Ivor Lewis procedure
Shortness of breath.
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Large opacity with air-fluid level projects over the right lung. Mediastinal surgical clips. Right internal jugular central venous catheter. Bibasal opacity and small left pleural effusion.
Types appearances post Ivor Lewis procedure. It is an oesophagectomy, gastric pull-up, and gastro-oesophageal anastomosis for disease (e.g. oesophageal cancer) in the distal two-thirds of the oesophagus.
The presence of surgical clips is key for not mistaking this for mega-oesophagus.