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Epigastric pain in a man with previous subtotal gastrectomy
  1. H-C Lai,
  2. C-C Tsai,
  3. C-L Feng,
  4. C-J Yu,
  5. J-W Chou,
  6. W-H Huang,
  7. C-H Hsu,
  8. K-S Cheng,
  9. C-Y Peng
  1. Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, Taichung, Taiwan
  1. Correspondence to Dr J-W Chou, Division of Gastroenterology and Hepatology, Department of Internal Medicine, China Medical University Hospital, No 2, Yuh-Der Road, North District, Taichung 40447, Taiwan; codecol{at}yahoo.com.tw

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Clinical presentation

A 68-year-old man presented to our hospital with a 2-day history of upper abdominal pain and non-bilious vomiting. Twenty years previously he had undergone a subtotal gastrectomy with Billroth II reconstruction because of a gastric ulcer. He denied alcohol consumption or trauma. Physical examination revealed that his upper abdomen was tender with muscle guarding and rebound tenderness. Laboratory tests showed the following: haemoglobin 11 g/dl (normal, 14–16 g/dl), white blood count 12.9×109/l …

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