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Case of the month: pseudo-pseudo-obstruction.

A 63-year-old man had recently undergone subtotal oesophagectomy for squamous carcinoma of the oesophagus. He had undergone a Heller's myotomy for achalasia of the oesophagus 30 years previously. A barium study was performed to evaluate post-operative swallowing and regurgitation problems. Unusual appearances were noted in the abdomen during screening. Plain films were taken after completion of the upper gastrointestinal study (Figure 1) and 2 days later (Figure 2).