Subepithelial Lesion in Bulb with Gastric Outlet Obstruction

Alireza Sharifi, Ahmad Hormati, Mohammad Reza Ghadir, Mohammad Bagheri, Mahboubeh Afifian


A 63-year-old man is referred to the Emergency Center with complaints of nausea, vomiting, and epigastric pain for 2 weeks. The patient occasionally mentions vomiting after meals and also complains of other symptoms such as bloating, heavy post-meal pain, and pain in the epigastric region with the vomiting. He notes that he has weight lost about 5 kg in the past three months. The pain in the epigastric area was worsened after eating, and following these symptoms, his appetite has decreased.

The patient does not give a history of any particular disease. The patient's vital signs are stable and are as follows:

Blood pressure: 120/100 mm Hg      pulse rate: 84/min        respiratory rate: 18/min

 body temperature: 36.5°C

The patient is generally pale in appearance but not icteric. The mucus was dry. In the clinical examinations, her abdomen was fatty, soft, and without distention. The patient had mild tenderness in the epigastric region, and no mass was touched. The rest of his examinations were normal.

The patient's laboratory findings indicate metabolic alkalosis. Table 1 summarizes the most important laboratory findings of the patient:

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