A 68-year-old woman presented with a 19-month history of generalized abdominal pain. Initially, she experienced the pain following meals, but subsequently the pain became persistent. Over this period of time, she lost 12 kg in weight. For the last few months before admission, she started having diarrhea once to twice per day. There was no blood or mucus in the stool. Her past medical history included partial gastrectomy 17 years earlier for benign disease. On examination, the patient looked cachectic. Her abdomen was slightly distended, and the bowel sounds were increased. There was a high-pitched epigastric bruit. Routine blood tests were normal.
Cancer of the pancreas
Subacute intestinal obstruction secondary to adhesions
Cancer of the large bowel
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