ABSTRACT
A 32-year-old man was admitted from the gastroenterology clinic for intravenous fluid administration. He had been referred to the clinic by his general practitioner 4 weeks earlier for investigation of intermittent vomiting. He gave a 4-month history of feeling nauseated throughout the day, initially associated with vomiting two to three times weekly, but this had since progressed to one to two times daily. There were no clear precipitants such as recent ingestion of food and no relieving factors. He usually vomited either food or bilious matter. There were no features suggestive of regurgitation and there was never any blood or coffee ground matter in the vomitus. There was no associated dysphagia or abdominal pain and his bowel habit remained unchanged. He was unsure how much weight he had lost but said that he was buckling his belt two to three notches tighter than he usually would and his clothes felt very loose. He denied any past medical history and took no regular medications. He worked as a legal aid advisor and lived alone. He had consumed no alcohol since the onset of his nausea and vomiting but did not drink to excess prior to this illness. He had never smoked and did not use recreational drugs.
