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An unusual cause of watery diarrhoea
  1. John N Gordon
  1. Department of Gastroenterology, St Mary's Hospital, Newport, Isle of Wight PO30 5TG, UK
  1. Dr Gordon (email:jngordon{at}

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A 40 year old housewife was referred with a nine month history of intermittent watery diarrhoea and intermittent abdominal pain. The diarrhoea occurred four to five times a day and there was no blood or mucus in the stools. Her only past medical history consisted of heartburn which was treated with ranitidine 150 mg twice a day by her general practitioner. She did not smoke and only drank occasionally. Physical examination revealed a 5 cm enlarged non-tender liver. Stool cultures revealed no growth. She underwent upper gastrointestinal endoscopy which revealed grade II oesophagitis and diffuse duodenitis and a small bowel series showed fine ileal ulceration. Colonoscopy was normal. Computed tomography of the abdomen showed multiple lesions throughout the right and the left liver highly suspicious of metastatic disease.


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