A 50-year-old man presented to the surgery department with epigastric pain and altered bowel habits for the past six months. He also lost 13 kg. The epigastric pain was present throughout the day and was persistent even after taking food. His stools were bulky, pale, and malodorous. Social history: He consumed a minimum of 10 units of alcohol per day and was a heavy smoker (one pack per day).
Medical history: The patient had previously been treated for alcohol dependence. Five years before presentation, the patient suffered from a duodenal ulcer, which was successfully treated with Helicobacter eradication therapy. Examination: Upon examination, the patient was observed to be pale, thin, and unkempt with a soft and non-tender abdomen and no palpable masses or organomegaly. There was no jaundice or supraclavicular lymphadenopathy. Oesophagogastroduodenoscopy and ultrasound of the abdomen…
