Woman With Coffee Ground Emesis

An 80-year-old woman who had undergone hemigastrectomy and Billroth's operation II gastrojejunostomy because of a perforated peptic ulcer 3 years previously presented to the emergency department with crampy epigastric pain, which had been followed by coffee-ground vomitus. Her vital signs were normal, and her physical examination demonstrated mild epigastric tenderness without peritoneal signs. Blood test results were negative. Abdominal radiograph (Figure 1) was performed, and computed tomography (CT) was subsequently obtained (Figures 2 and 3).

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