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A 69-year-old man, otherwise well, except for ischaemic heart disease and asthma, presented with a 2 year history of crampy abdominal pain relieved with vomiting, intermittent diarrhoea up to 15 times per day and associated 20 kg weight loss. Physical examination revealed a soft abdomen with mild distension. Initial laboratory data were normal. Multiple stool cultures were negative. Plain abdominal radiography and CT revealed dilatation of multiple loops of small and large bowel.
Metabolic, autoimmune, infectious including HIV and tuberculosis), as well as a carcinoid screen including an octreotide scan …