Editor's quiz
Does old age cause abdominal pain?
Elisabethinen Hospital, Linz, Austria
Correspondence to:
Dr D Schiller, Elisabethinen Hospital Linz, Fadingerstr. 1, A-4010 Linz, Austria; dietmar.schiller@elisabethinen.or.at
| The first 150 words of the full text of this article appear below. |
CLINICAL PRESENTATION
An 87-year-old woman presented with abdominal pain and weight loss of 12 kg. She had been in an excellent state of health until 6 months previously and had not been taking any regular medication. Her family history was unremarkable.
The pain occured in all four abdominal quadrants, was colicky and most severe postprandially. She reported occasional nausea without vomiting. There was a tendency for loose stools.
On examination she was apyrexial and had a body mass index of 16 kg/m2. Her abdomen was slightly tender on palpation. Cardiovascular and lung findings were normal.
Abdominal ultrasonography, oesophagogastroduodenoscopy, colonoscopy, small bowel imaging, and pancreatic computed tomography (CT) yielded normal results.
Extensive laboratory work-up including urinary porphyrins and C1 esterase inhibitor activity was negative. Adrenal insufficiency was ruled out by an adrenocorticotrophic hormone (ACTH) stimulation test.
Finally, an abdominal CT scan suggested a possible cause of her abdominal pain (fig 1
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ANSWER
Gut 2009 58: 536.[Extract] [Full Text] [PDF]
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