Inversion of the Left Hemidiaphragm

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Abstract
The left hemidiaphragm is sometimes inverted by pleural effusion on the left and may simulate primary abdominal disease roentgenographically. The clinical findings include severe dyspnea and evidence of pleural fluid. There is no palpable mass which correlates with one sometimes seen on the abdominal x-ray film. An inverted diaphragm displaces adjacent abdominal structures and moves paradoxically so a normal spleen may be palpable and also move paradoxically. The diagnosis can be confirmed by thoracentesis and/or diagnostic pneumoperitoneum. Occasionally, diagnostic pneumothorax is helpful.

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