Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles.
Thank you for the CT image and the accompanying summary. This is an unusual condition and your report brings it to our attention. I am writing to mention that another potential cause is an upper-GI anastomosis, and particularly one between stomach and small intestine, and I have seen a recent case after a Whipple's operation (Billroth 2 reconstruction of the stomach).
Sean Mackay MBBS MD FRACS
No competing interests
22 September 2019
Sean DP Mackay
HPB, Upper GI, and Bariatric surgeon, Senior Lecturer
Eastern Health Medical School, Monash University, Melbourne, Australia
Eastern Health Clinical School, 5 Arnold St, Box Hill 3128, Melbourne, Victoria, Australia