Peptic Ulcer Disease

Abstract

A 51-year-old man was admitted to University Hospital in August 1986 with a three-day history of intractable nausea and vomiting, moderate epigastric pain, and blood-streaked emesis on the day of admission. He had become progressively weak, lightheaded, and faint when standing, and was unable to retain medication or liquids at home. His prior history was relevant for emergency ulcer surgery nineteen years previously, believed to be for perforation. Details of the operation were not known to the patient and records were not immediately available. Since then, he had experienced episodic pain, nausea and vomiting for a few days every year or so. These symptoms were usually relieved by fasting and antacids. He had sought little formal medical care but periodically received a prescription for Cimetidine from a public clinic and used it for indigestion, pain, or emesis. Past history was otherwise not remarkable. Family history included peptic ulcer disease in the father; no details were known to the patient. The patient worked part-time parking cars, was married, and smoked two packs of cigarettes daily. He denied past or present alcohol or drug abuse, or use of any other medication.