Man With Persistent Vomiting

Abstract

An 80-year old man with a history of hypertension and Parkinson disease presented to the emergency department with persistent vomiting and vague abdominal pain for 2 days. His vital signs were stable, and he was afebrile. An abdominal radiograph (Figure 1) showed a severely distended stomach. After decompression by nasogastric tube, a large amount of bilious material was drained. The blood tests revealed only mild anemia (hemoglobin, 11.4 g/dL) and hypokalemia (3.09 mmol/L). A point-of-care abdominal ultrasound scan was performed (Figure 2).