Case 16

An eighty five-year-old female came to our hospital for vomiting and fever. That morning, she had breakfast as usual. At lunch, she had a small volume of food because of uncomfortable feeling. One hour later, nausea and vomiting occurred. After lying in bed for a while, nausea improved but mild fever was noted. Then, she visited us to check what happened to her. She vomited again at our hospital, with no-bloody and no-bile emesis. Laboratory test: white blood cells 5220/mm³, Neutophils 83.9 % (40-71), Amylase 445 U/L (37 – 120) Blood sugar 130 mg/dL(75 – 110), CRP of 0.04 mg/dl.

Which is the diagnosis ?

1.Esophageal hiatal hernia

2.Diaphragmatic hernia

3.Superior mesenteric artery syndrome

4.Gastric volvulus

5.Gastric cancer at pylorus

answer

2016.7.27