A 10-day-old boy was referred for repair of left-side diaphragmatic hernia (Fig. 1). The following day he developed worsening respiratory distress. A follow-up chest radiograph showed a large, oval-shaped radiolucency suggesting massive intrathoracic gastric dilatation, presumably through the diaphragmatic hernia (Fig. 2). At surgery, an organoaxial gastric volvulus through a Bochdalek hernia was found. There were multiple decompressed bowel loops posterior to the gastric volvulus.
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