Figure 20c. Esophagopleural fistulas. (a) Transverse nonenhanced CT scan in a 43-year-old woman shows large air-fluid collection in left pleural space (P) that encroaches on the esophagus (arrow). (b) Subsequent esophagogram shows contrast agent leak (arrowheads) from the distal esophagus into empyema. (c) Transverse contrast-enhanced CT scan in a 29-year-old man with a history of radiation therapy for Hodgkin disease shows communication (arrow) between esophagus and apical hydropneumothorax (P). L = aerated right upper lobe.