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Case Records of the Massachusetts General Hospital
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Volume 352:817-825 February 24, 2005 Number 8
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Case 6-2005 — A 58-Year-Old Man with Esophageal Cancer and Nausea, Vomiting, and Intractable Hiccups
Eric L. Krakauer, M.D., Ph.D., Andrew X. Zhu, M.D., Ph.D., Brenna C. Bounds, M.D., Dushyant Sahani, M.D., Kevin R. McDonald, M.D., and Elena F. Brachtel, M.D.

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Presentation of Case

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 . . . [Full Text of this Article]

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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