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Ivor Lewis procedure

Case contributed by Henry Knipe
Diagnosis almost certain

Presentation

Chest pain for investigation.

Patient Data

Age: 50 years
Gender: Male
x-ray

Opacity projecting over the paraspinal region with mediastinal clips are noted. 

Case Discussion

Chest x-rays post Ivor Lewis procedures (distal esophagectomy with gastric pull-up) can have a variety of appearances. The only true clue here are the mediastinal surgical clips with the classic air-fluid absent. 

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