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Article
April 28, 1956

UNUSUAL CAUSE OF FLUID LEVEL IN THE UPPER MEDIASTINUM

JAMA. 1956;160(17):1533. doi:10.1001/jama.1956.02960520095019

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Abstract

To the Editor:—  We wish to report an additional possibility to be included in the differential diagnosis of fluid level in the upper mediastinum. In our patient the fluid level was caused by a chronic, long-standing stenosis of the esophagus after ingestion of lye. Among the more common causes of mediastinal fluid levels one must consider, first, mediastinal abscess, or, less frequently, esophageal diverticulum, mediastinal cyst, diaphragmatic hernia, or cardiospasm. A 52-year-old woman was referred for a radiological examination because of fever of one week's duration and a slight cough. The standard posteroanterior roentgenogram of the chest showed in the upper mediastinum a large fluid level with no other significant pathological findings (see figure, A). A lateral roentgenogram localized the fluid level to the posterior upper mediastinum and showed the trachea to be displaced forward by this mass. The possibility of an esophageal cause was considered, and an esophageal examination

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