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The clinical onset of coeliac disease may be precipitated by upper digestive tract surgery. A 66-year old woman with asymptomatic coeliac disease that became clinically evident after oesophagectomy and vagotomy is presented. The surgery was performed for a squamous carcinoma of the hypopharynx. There had been no signs or symptoms of coeliac disease preoperatively. Persistent untreatable hypocalcaemia after the operation suggested the diagnosis. The role of surgery in unmasking asymptomatic coeliac disease is discussed.