Statistics from Altmetric.com
A 59 year old man was admitted with a three day history of haematemesis and malaena. He was known to suffer from hyperlipidaemia and type II diabetes. He had a history of acute gall stone pancreatitis complicated by pseudocyst formation and treated with an open cystgastrostomy in 1996. He drank less than 20 units of alcohol/week and was a non-smoker. His medication included aspirin, metformin, and simvastatin. On admission he was hypotensive (90/70 mm Hg) and tachycardic. There were no clinical signs of stigmata of chronic liver disease. Abdominal examination was unremarkable. On admission, haemoglobin was 4.4 g/dl, international normalised ratio 1.4, urea 21.2 mmol/l, and glucose 30.4 mmol/l. The patient was resuscitated with blood and intravenous crystalloid and underwent an urgent upper gastrointestinal endoscopy followed by an abdominal computed tomography (CT) scan.
What does the duodenal endoscopic image (fig 1) demonstrate? What is shown on the abdominal CT scans (figs 2, 3)?
See page 113 for answer
This case is submitted by:
If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.