A 61-year-old woman.
Asthma was diagnosed with hypothyroidism under treatment due to second degree atrioventricular block.
Acetatomised in childhood.
She came to the emergency department with acute abdominal pain type discontent associated with early satiety, postprandial nausea and vomiting for 2-3 months.
During this time you lost 10 kg of weight.
Examination revealed a distended, tympanic, diffusely painful abdomen due to palpation without signs of irritation.
Metallic noises.
An abdominal X-ray was performed in the emergency room, showing marked gastric and duodenal dilation (double bubble sign).
Gastroscopy showed a stomach with almost absent motility and presence of food debris.
The duodenum is edematous with impossibility of passing to the second portion, biopsies are taken that were subsequently reported as nonspecific duodenitis with absence of malignant cells.
Abdominal CT shows gastric and duodenal dilation with stenosis in the third portion of the duodenum.
These results were obtained with barium EGD, which showed 3 stenoses with regular margins in the second-third of the duodenum, with contrast-enhanced diffi cult passage, compatible with diaphragm.
Given the findings, the patient was re-historyed that she had always had early satiety and slow digests, being always a very thin person of short size.
Gastroenterostomy was performed in Y Roux.
