Ivor Lewis procedure

Case contributed by Dr Henry Knipe

Presentation

Shortness of breath.

Patient Data

Age: 50 years
Gender: Female
x_ray

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. 

Case Discussion

Types appearances post Ivor Lewis procedure. It is an esophagectomy, gastric pull-up, and gastro-esophageal anastomosis for disease (e.g. esophageal cancer) in the distal two-thirds of the esophagus. 

The presence of surgical clips is key for not mistaking this for mega-esophagus

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