There is an air-fluid level evident in the large sliding esophageal hiatus hernia.
http://eradiology.bidmc.harvard.edu/Classics/item.aspx?section=Emergency+Radiology&labelpk=33f0adab-853f-4010-a0e2-0756b3f1eac5&pk=711cae78-b173-48e2-989a-b7530cc3b42f
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