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A 34-year-old woman with a nine-month history of postprandial dyspnea and substernal fullness had severe pain in her epigastrium, without emesis, shortly after the ingestion of an evening meal. On examination, she had audible bowel sounds, mild epigastric tenderness without rebound, and no palpable masses or organomegaly. A stool specimen was negative for occult blood. The results of laboratory tests were as follows: hemoglobin level, 12.8 g per deciliter; hematocrit, 37 percent; mean corpuscular volume, 86 µm3; and white-cell count, 7400 per cubic millimeter. Posteroanterior and lateral chest radiography revealed a large intrathoracic gastric bubble (Panels A and B), . . . [Full Text of this Article] |