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Upper gastrointestinal series demonstrating a Roux-en-Y gastric bypass with a gastrogastric fistula and leak under the left hemidiaphragm (arrows, top and bottom left) as evidenced by contrast filling of an irregularly shaped cavity lateral to the gastric pouch, which spontaneously empties back via the gastric pouch. This patient eventually required a distal esophagectomy, total gastrectomy and esophagojejunostomy (bottom right).
