A reduction in the size of enlarged lymph nodes after neoadjuvant therapy may be a useful prognostic factor for recurrence and survival.

Diaphragmatic hernia should be considered in patients with pleural effusion, abdominal pain and vomiting.

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We report a case of bloody pleural effusion and infarction of the greater omentum caused by a non‐traumatic diaphragmatic hernia with a late presentation. A 15‐y‐old boy with Down's syndrome developed abdominal pain and vomiting, as well as an elevated serum level of C‐reactive protein. Chest roentgenograms showed a right‐sided pleural effusion and computed tomography revealed a right diaphragmatic hernia. Barium enema confirmed the diagnosis. An operation revealed a right Bochdalek's hernia with strangulation of the greater omentum in the right pleural cavity. Conclusion: Diaphragmatic hernia should be considered in patients with pleural effusion, abdominal pain and vomiting.

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