Case 23-1969

Presentation of CaseA sixty-five-year-old woman was admitted to the hospital because of anorexia, nausea, weight loss and abdominal pain.She had been well until five weeks previously, when crampy lower abdominal discomfort developed. The discomfort increased and was associated with severe constipation. Four days before admission the pain became more severe, with radiation to the back. She did not vomit but was unable to eat solid food. There had been no fatty-food intolerance, fever, chills, diarrhea or vomiting. During the week before entry she lost 8 to 10 pounds in weight. An upper gastrointestinal series a few days before . . .