Case 57-1961

Presentation of CaseA thirty-four-year-old woman entered the hospital because of weakness and icterus.Eight months previously, after the excision of a pilonidal cyst at another hospital, gradually increasing fatigue and anorexia, with occasional nausea and vomiting, developed. During that time she lost 40 pounds in weight. Two months before entry progressive swelling of the abdomen appeared, with associated diffuse, aching abdominal pain and eructation. Vomiting without hematemesis began to occur about twice weekly, and she complained of mild epistaxis and easy bruising of the skin. The weakness became extreme, and she spent the major part of the two weeks . . .