An 84-year-old woman is brought to the emergency department (ED) because of a 2-day history of nausea and intractable vomiting. On arrival, the patient appears somnolent but is arousable to verbal stimulation. She has lost more than 20 pounds of weight over the past few months, which she attributes to poor appetite. She has not passed any stool or flatus for more than 3 days. She has a history of hypertension and hypercholesterolemia. Medications include lisinopril (10 mg daily) and hydrochlorothiazide (25 mg daily).
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Patrick Kortebein, MD
Joseph LoCicero, MD
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