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75-Year-Old Man With Abdominal Pain and Weight Loss

A 75-year-old man presented to the outpatient clinic with a 9-kg weight loss during the preceding several months and mild midepigastric pain radiating to the back. His medical history was unremarkable. He was a former smoker and lifelong nondrinker. Review of systems was notable only for a slightly decreased appetite, but no nausea, vomiting, or diarrhea was reported. On physical examination, the patient was afebrile and had normal vital signs. However, cachexia and jaundice with scierai icterus were evident. Abdominal examination revealed mild midepigastric tenderness without rebound, guarding, or hepatosplenomegaly and a negative Murphy sign. Findings on the rest of the physical ...

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