The large left congenital diaphragmatic hernia is visible on day 0 with gas-filed stomach and small bowel in the left hemithorax.

Over the first two days, there was progressive deaeration of the herniated viscera. The mass effect is significant and causes mediastinal shift and compressive atelectasis of the right upper lobe.

Managing these cases is not as simple as pulling down the bowel and sewing up the hole in the diaphragm - there will be assocaited pulmonary hypoplasia because of the lack of pulmonary expansion in utero and respiratory compromise is often severe in cases with large herniae.