A 47-year-old man was referred from the emergencyroom for further management of intestinal obstruction. Thepatient presented with a long history of epigastric discomfortassociated with abdominal distension. His bowelhabits had never changed. He did not report any loss ofweight or appetite. His past surgical history included alaparotomy performed 20 years before for an obstructedpeptic ulcer treated by bilateral truncal vagotomy and gastrojejunostomy(Bilroth 2 procedure). On admission, thepatient’s abdomen was slightly distended with no abdominalmass.
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