Case 43252

Presentation of CaseA fifty-six-year-old man was admitted to the hospital because of abdominal pain.Eight months previously a subtotal gastrectomy was performed at another hospital because of a duodenal ulcer. The patient had had persistent gnawing epigastric pain that radiated to the back and was relieved by food and antacids. There was one episode of bleeding. Postoperatively he was well until four months before entry, when there were episodes of discomfort and fullness in the lower abdomen, with some crampy pain that lasted one or two hours. Constipation was noted. During the three months before admission the abdominal discomfort . . .