The CXR shows a lucent shadow with an air fluid level in the lower mediastinum. This is typical of a hiatus hernia because of its midline position with the stomach herniating through the esophageal hiatus. Also the stomach bubble is not seen in its usual position. A barium swallow or CT with oral contrast can be done in doubtful cases.
Case 55. This patient gave a history of tuberculosis in the 1950s for which surgery was performed. The CXR is shown (Fig. 55.1).
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