Case 307

Area of Science:

• Gastroenterology
• Nuclear Medicine
• Radiology

Background:

• A 45-year-old woman presented with a 4-year history of worsening nausea, nonbilious vomiting, and mild upper abdominal pain.
• Routine investigations and tumor markers were unremarkable, necessitating further diagnostic evaluation.

Observation:

• Clinical examination revealed stable vital signs and a benign abdominal exam.
• Initial contrast-enhanced CT of the abdomen and pelvis showed no definitive pathology.
• An indium 111 octreotide scan was performed subsequently for further assessment.

Findings:

• The patient's prolonged gastrointestinal symptoms were unexplained by initial laboratory and imaging studies.
• The diagnostic workup involved a multi-modal imaging approach.

Implications:

• This case highlights the importance of considering advanced imaging techniques when initial evaluations are inconclusive for chronic gastrointestinal complaints.
• Further investigation with somatostatin receptor scintigraphy (indium 111 octreotide scan) may be beneficial in diagnosing rare conditions presenting with unexplained nausea and vomiting.