ABSTRACT
The hospital crash team was called to attend to a 23-year-old man who was found collapsed in a corridor outside the emergency department. He complained of feeling very fatigued and light-headed, and described his legs giving way. He had been advised to attend the department by his work colleagues who noticed that he had become progressively more unwell over a period of several days. He gave a 4–6 week history of anorexia and weight loss (estimated to be around 10 kg over 4 weeks). He attributed his reduced oral intake to vague abdominal discomfort and nausea. He had vomited two to three times over the last few days. He denied loose stools or constipation. On direct questioning, he admitted to two recent episodes of urinary incontinence, which he described as ‘not quite making it to the bathroom on time despite rushing there’. When asked if he had noticed that his urine was dark and his stools were pale, he admitted to very dark urine but was unsure regarding stool colour. He had no past medical history and took no regular medications. He was an office worker who lived alone and had one long-term female sexual partner. He drank 6–8 units of alcohol per week and neither smoked nor used recreational drugs. He had not travelled abroad in the past 1 year.
