Description

A 62-year-old woman presented with a 2-year history of abdominal pain, weight loss and diarrhoea. Her medical history included well-controlled epilepsy, migraine, hypothyroidism and depression with previous drug overdose. She was a long-term smoker. She had been referred to gastroenterology outpatients twice already by her general practitioner as suspected malignancy.

She described a 2-year history of worsening epigastric and more generalised abdominal pain that was typically postprandial and dull and ‘gnawing’ in nature. Pain was usually followed by non-bloody diarrhoea occurring up to seven times a day. She reported that pain was limiting her oral intake and over …