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Miscellaneous
An unusual cause of gastric outlet obstruction
  1. A M Smith1,
  2. R Mackey2,
  3. R M Walsh2
  1. 1Academic Surgical Unit, Castle Hill Hospital, Cottingham, East Yorkshire, UK
  2. 2Department of Surgery, A80 Crile Building, Cleveland Clinic Foundation, Euclid Avenue, Cleveland, Ohio, USA
  1. Correspondence to:
    MrA M Smith
    Academic Surgical Unit, Castle Hill Hospital, Cottingham, East Yorkshire HU16 5JQ, UK; malvernhome{at}hotmail.com
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http://dx.doi.org/10.1136/gut.2005.080846

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    Clinical presentation

    A 70 year old female presented with a four week history of epigastric pain, nausea, bilious vomiting, and weight loss of 20 lb. Forty years ago she had undergone a proctocolectomy for familial adenomatous polyposis (FAP). On examination she was apyrexial, tachycardic (120), normotensive, and dehydrated. Her abdomen was soft with a succussion splash. She was initially rehydrated and her stomach was decompressed with a nasogastric tube. She then underwent a computed tomography scan.

    Question

    What is the abnormality marked with the arrows in fig 1? What is the diagnosis and management?

    Figure 1
    Figure 1

     Computed tomography scan.

    See page 977 for answer

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    Copyright 2006 by Gut

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      BMJ Publishing Group Ltd and British Society of Gastroenterology
      Gut 2006; 55 977-977 Published Online First: 09 Jun 2006.