Case presentation A 50-year-old man presented to the clinic with a one-year history of post-prandial nausea and vomiting, progressive epigastric abdominal pain, anorexia, and 27 kg weight loss. He had presented with the same complaints to another clinic four months ago. He underwent laparotomy with a diagnosis of small bowel obstruction with temporary symptomatic relief. The patient has a moderately distended, non-tender abdomen. He is unable to ingest food orally and is on parenteral nutrition.
Medical history The patient had a history of prostate cancer and underwent a robotic prostatectomy two years ago. Laboratory examination The blood test QuantiFERON – TB Gold was positive and suggestive of tuberculosis. Imaging studies An abdominal CT scan showed a dilated stomach and duodenum with a decompressed, thickened small bowel. An exploratory laparotomy was ordered that revealed a thick…
