ABSTRACT
A 57-year-old man presented to hospital complaining of right-sided abdominal pain and vomiting. His symptoms had come on gradually 8 months earlier and had been gradually worsening. He felt nauseated for most of the day and often vomited after meals. He described a sensation of early satiety and a dull pain over the right side of his abdomen on eating or coughing. He had unintentionally lost around 10 kg of weight over 6 months. His past medical history included an episode of alcoholic hepatitis 10 years earlier. He took no regular medications. He worked as a farmer in New Zealand and had lived there for the past 35 years. He had returned to the United Kingdom 2 weeks earlier. He did not drink alcohol at present but had a past history of alcohol misuse. He did not smoke tobacco or use recreational drugs. He had no recent sexual partners.
