Figure 1.

Preinterventional lateral and dorsoventral thoracic radiographs. (a) Ventrodorsal projection. Note the moderate distention of the caudal esophagus. (b) Right lateral projection. Note the presence of gas within the soft tissue mass at the level of the caudal esophagus and the dorsal displacement of the mid-to-caudal sternebral segments due to increased inspiratory effort and respiratory distress. (c) Left lateral projection with the patient intubated. Note how the patient’s sternebral deformity and the mass at the level of the caudal esophagus resolve with assisted ventilation. Findings were consistent with sliding hiatal herniation. Dynamic changes in the sternebral segments coupled with increased respiratory effort raised suspicion of an upper airway obstruction, which was likely exacerbated by the stress of restraint for thoracic imaging