What's your diagnosis? – Case 1: vomiting and weight loss

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Every Thursday we will publish a different 'What's your diagnosis' question and give you the chance to tell us what you think the patient suffers from. 

The patient's symptoms

Mrs K (30), a cashier at a local shop, recently noted that she tires easily during the course of her daily work.

About a month ago she started vomiting after each meal.  Usually, in women her age, losing weight is considered a plus, but Mrs K started to worry when her dress size dropped from a size 14 to a size 12 in less than a month. 

Mrs K does not have a family history of any illness, and apart from having a mole removed from the sole of her foot about six months ago, she has never undergone any surgery.

Her friend, Annie, also noted that Mrs K is looking paler than usual.  

Her biggest concerns are the regular vomiting episodes and constant tiredness.

On examining her abdomen, Mrs K's doctor found the most likely cause of her vomiting bouts.

What's your diagnosis?

To help you figure out what ails her, answer the following questions:

1.            What did her doctor find during the abdominal exam that may be the cause of vomiting AFTER meals?

2.            Are there any special tests that should be performed on Mrs K?                   

3.            Do you think Mrs K’s prior medical condition (removal of the mole) is of concern?

Answer:

Mrs K’s mole turned out to be the culprit. Her abdominal examination revealed a massively enlarged liver which was also the cause of her vomiting (the enlarged organ pressed on her stomach).

On further examination the mole turned out to be an incompletely excised malignant melanoma which spread to her liver and possibly other organs. Her tiredness and pale appearance can be attributed to anaemia of a chronic illness (in her case most likely the cancer). For the Full Answer click here.

NOTE: Health24's on-site GP Dr Owen Wiese will reveal new cases on Thursdays and we'll post the answer with the story on Mondays, or you can find out via the Daily Tip – sign up here.

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