Chronic abdominal pain.

Accepted 20 March 1997 A 55-year-old man presented with a two-year history of post-prandial epigastric pain and 10 kg weight loss. He smoked 20 cigarettes per day and suffered intermnittent claudication. Physical examination revealed bilateral absence of dorsalis pedis and anterior tibial arterial pulsation. His symptoms continued for a further two years and his weight fell by a further 3 kg. Over this time he was extensively investigated by several surgeons and physicians. Blood count, urea and electrolytes, liver function, gastroscopy, endoscopic retrograde cholangiopancreatography, barium meal and follow-through, abdominal ultrasound scan, and barium enema were all normal. Twenty-eight months after presentation a diagnostic procedure was performed and curative treatment given. He has suffered no symptoms since and has regained 6 kg in weight.