Case 35071

Presentation of Case First admission. A forty-six-year-old carpenter was admitted to the hospital because of epigastric distress of eight years' duration.The pain usually developed in the midafternoon and was promptly relieved by food or soda. On one occasion he vomited large quantities of bright blood.Physical examination revealed a well developed man, with a blood pressure of 130 systolic, 80 diastolic. There was moderate exophthalmos and slight lid lag. The skin was slightly dry and cool. Examination of the chest and abdomen was negative. Urine, blood and stool examinations, including guaiac tests, were negative. Gastric analysis revealed 33 . . .