Figure 1
Axial (A) and coronal (B) contrast‑enhanced CT images obtained two months before the current presentation show an infiltrative hypodense splenic mass abutting the left hemidiaphragm and adjacent to the stomach, without clear signs of invasion.
Figure 2
Multiple air–fluid levels in the left hemithorax, consistent with hydropneumothorax.
Figure 3
Contrast‑enhanced CT images demonstrate a gastrosplenic fistula (red arrow in A) and a diaphragmatic defect (green arrow in B), resulting in leakage of gastric contents into the pleural cavity and the development of a multiloculated hydropneumothorax (C and D).