Case 18-1963

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Abstract
Presentation of Case First admission. A sixty-five-year-old woman entered the hospital because of pain in the abdomen and vomiting.Five days before entry she had the sudden onset of severe, diffuse, crampy abdominal pain, followed by intermittent nausea and projectile vomiting. The pain was less severe after episodes of vomiting. There was no hematemesis, melena or jaundice. No stool was passed over a four-day period; the urinary output was scant, but there was no hematuria or dysuria.One year before admission the blood pressure was elevated to 190 systolic, 110 diastolic, dropping to 170 systolic, 88 diastolic, after rest; at . . .

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