Asian Cardiovasc Thorac Ann 2006 Jun; 14(3): e60-2 (Read article online)

Huwer H, Winning J, Isringhaus H, Kalweit G

Following right-sided pneumonectomy and hemidiaphragm resection in a 58-year-old man with epithelioid mesothelioma, acute respiratory insufficiency and life-threatening circulatory collapse developed after a forced Valsalva maneuver. Major pulmonary embolism was diagnosed on clinical grounds, however computed tomography revealed herniation of the liver into the right hemithorax.