Author: Peter von Hoven / Editor: Sarah Edwards / Codes: GP10, GP4, GP9, SLO1, SLO2 / Published: 19/10/2021

Mr Ship is a 94-year-old male who lives alone in his home, and is fully independent for all his activities of daily living. He presents to the Emergency Department (ED) complaining of vomiting every time he eats.

For the last 5 weeks Mr Ship has been complaining of vomiting after everything he eats. He is only able to keep a small amount of Weetabix down in the morning, and then has to survive on liquids from then on. He will still vomit small amounts of liquid. His vomit is clear with no blood. He also feels as though his trousers are starting to feel looser. He has put this down to poor oral intake. He has no abdominal pain, and his bowels continue to open every other day.

He has had multiple ERCP’s for recurring cholangitis, and is on 30mg Lansoprazole for GORD following a recent presentation to the ED.

On examination his abdomen is soft non tender, bowel sounds present, and his bloods are all normal.

His past medical history includes hypertension, and barrettes oesophagus.

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