Vomiting and weight loss.

Accepted 28 February 1996 A 25-year-old woman presented with a history of burning in the epigastrium, delayed postprandial vomiting and a weight loss of 5 kg over six months. There was no history of any gastrointestinal bleeding, altered bowel habits, fever, anorexia, respiratory symptoms, or treatment for tuberculosis. Examination of the abdomen revealed mild epigastric tenderness but no palpable lump. Respiratory and cardiovascular examination was normal. Laboratory investigations revealed a haemoglobin of 13.6 g/dl, white blood cell count of 4.2 x 109/1 with a normal differential count. The erythrocyte sedimentation rate was 64 mm/h. The liver profile, renal profile, urine and stool analysis were within normal limits and chest X-ray and electrocardiogram were also normal. A barium meal study was performed (figure).