CLINICAL HISTORY.—A 12-year-old boy arrived in the radiology department of the Pediatric Institute in Krakow, Poland, complaining of pain in the left upper portion of the abdomen and left lower portion of the thorax. His pain began 24 hours previously. No vomiting has occurred.
Physical Examination.—He appeared in distress and walked bending forward. There were decreased breath sounds in the left lower portion of the thorax. The left upper portion of the abdomen was tender to palpation. No other abnormalities were detected by physical examination. The laboratory findings were all within normal limits.
A series of x-ray films of the upper-gastrointestinal tract was obtained (Figure).
Denouement and Discussion
Acute Flexura Lienalis Syndrome
The barium meal shows interposition of the splenic flexure of the colon between the diaphragm, stomach, and spleen. The left leaf of the diaphragm was somewhat high in position but had slight movement with respiration.The