Case 40081

Presentation of Case First admission. A fifty-nine-year-old housewife entered the hospital complaining of stiffness and aching in the legs.Four years before admission she began to have "rumbling" in her stomach. After three or four months watery diarrhea slowly started and increased to a peak of 8 to 10 stools a day two years before entry. The appetite decreased and the weight fell from the usual 170 pounds to 110 pounds. The stools never contained blood, pus or mucus, nor were they foamy or foul smelling. Two years before admission, x-ray studies showed multiple laminated gallstones by Graham test . . .