Chest radiograph (A) shows a large left hydropneumothorax with slight cardiomediastinal deviation to the right. Chest computed tomography (CT) scan (B) shows residual anterior loculated hydropneumothorax (black arrow) and a left chest tube and a stent covering the lower esophageal perforation (black dashed arrow). A left hemorrhagic loculated basal pleural effusion with higher attenuation (black arrowhead) is also seen in the left paravertebral location, displacing and compressing the left lower lobe. Contrast esophagram (C) shows extravasation of contrast material into the left hemithorax (white arrow). A white dashed arrow points to the stenotic esophageal segment, likely a sequela of Barret's esophagus. The white arrowhead points to a small axial hiatal hernia.
