Figure 11a. Bypass surgery (esophagocologastrostomy) in a 57-year-old man with esophageal obstruction due to lower esophageal cancer. The patient underwent palliative surgery for hepatic metastases. (a) Pre-operative CT scan (5-mm section thickness) obtained at the level of the left atrium shows a bulky obstructing mass (arrow) in the lower thoracic esophagus. (b) Postoperative barium esophagogram shows substernal right colon interposition between the esophagus and the stomach.