A 50-year-old presented to the ER with history of a road side accident. Patient was unconscious. e-Fast revealed fluid in the pelvis. Chest x-ray is given below. CT scan What is the most likely diagnosis in the above patient: -

This is a case of diaphragmatic injury with herniation of bowel loops herniating into the thoracic cavity. Chest x-ray shows multiple air fluid levels in the right thoracic cavity - suggestive of bowel loops herniating into the thoracic cavity. CT scan shows discontinuity of diaphragm and herniation of bowel loops into the thoracic cavity. No hyperlucency with absence of bronchovascular markings seen in thorax - ruling out pneumothorax. No signs of pulmonary embolism seen. No opacification with detion of mediastinal structures to the ipsilateral side is seen - rules of collapse of lung.