Paraesophageal diaphragmatic hernia, pyloric stenosis from a benign ulcer

A 65 year old man presents at the emergency department with abdominal pain, vomiting and a palpable abdominal mass.

	Circular radiotranslucent area posterior to the heart on the left.
	Large fluid level below the diaphragm on the left.
	Large soft tissue mass in the mid-abdominal area.