Diaphragmatic eventration and Chilaiditi sign
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Left-sided double lead pacemaker device remains well positioned and the leads intact. The lungs and pleural spaces are clear. No pneumothorax. No signs of pulmonary edema. Heart size is enlarged even allowing for projection. Right hemidiaphragm eventration containing large bowel is unchanged. No mediastinal contours and hila are normal. No free subdiaphragmatic gas. The lower thoracic crush fracture has reduced in height slightly more since the previous study.
A segment of large bowel is seen beneath the right diaphragmatic eventration, which may mimic pneumoperitoenum (pseudopneumoperitoneum). The other differential for this case is a cavitation lung lesion such as a lung cancer or abscess if the patient was sick.