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Dr. Kevin R. McDonald: A 58-year-old man was transferred to this hospital for management of newly diagnosed adenocarcinoma of the esophagus.
Several months before admission, the patient initially had episodes of early satiety and then began to vomit all solid food. He lost 14 kg; light-headedness and dyspnea with minimal exertion developed. He did not have nausea, dysphagia, or odynophagia, but he was able to ingest only small amounts of liquids slowly without vomiting. Twelve days before admission, he went to the emergency department of another hospital.
An initial evaluation at that hospital revealed guaiac-positive stool, a hematocrit of 12
Differential Diagnosis
Pathological Discussion
Discussion of Management
Acute Palliative Care
Differential Diagnosis of Nausea and Vomiting in Patients with Cancer
Differential Diagnosis of Hiccups in Cancer Patients
Discussion of Management
Final Diagnosis
Source Information
From the Palliative Care Service (E.L.K., K.R.M.), the Division of Hematology and Oncology (A.X.Z.), the Gastroenterology Unit (B.C.B.), and the Departments of Radiology (D.S.) and Pathology (E.F.B.), Massachusetts General Hospital; and the Departments of Medicine (E.L.K., A.X.Z., B.C.B., K.R.M.), Radiology (D.S.), and Pathology (E.F.B.), Harvard Medical School.
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