What is the most likely cause of this physical finding?
Correct Answer: Esophagogastric bypass
Description: Answer B. Esophagogastric bypassEsophagogastric bypass is the correct answer. This patient had an subcutaneous esophagogastric bypass procedure over 50 years ago as a result of a complete esophageal stenosis due to a chemical burn. The examination finding is notable for the subcutaneous colonic segment on the chest wall as well as the proximal jejunum as a result of herniation through the epigastric opening of the abdominal fascia created for the esophagogastric bypass. This subcutaneous approach was chosen at the time to avoid additional complications of surgery and anesthesia related to thoracotomy or retrosternal tunneling.
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