Gastrointestinal System

{"ops":[{"insert":"Diagnosis and reasoning"},{"insert":"\n","attributes":{"header":1}},{"insert":"This patient has presented with chronic epigastric pain in association with a large epigastric mass.\n\nThis is an extremely concerning duet of clinical findings; it is essential to determine if a gastric or pancreatic malignancy might be present.\n\nOther potential causes for this presentation include enlargement of the left lobe of the liver secondary to primary hepatocellular carcinoma or hepatic secondaries; pancreatic pseudocysts; an epigastric hernia; abdominal aortic aneurysms (AAA); and retroperitoneal lymphadenopathy.\n\nAnalysis of the salient points in her history and examination are key towards narrowing down the above list of differentials.\n\nIn this regard, note the presence of vomiting between 20 to 30 minutes following meals - this"}]}

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