Twenty years ago, he had a vagotomy and pyloroplasty for a bleeding duodenal ulcer and was asymptomatic before the current illness. Physical examination is normal except for mild tenderness in the epigastric region. 63 year old man develops jaundice one day after having partial gastrectomy for massive upper gastrointestinal bleeding secondary to hemorrhagic gastritis. He had received 10 units of packed erythrocytes during surgery. There is no previous history of liver disease.
Physical examination shows jaundice.
The abdomen could not be examined adequately because of the surgical wound. Telangiectasias 27.A 64 year old man with thirty years of hypertension, has weakness of arms and legs for seven months. He takes enalapril and colchicine daily. Physical examination reveals inability to rise from a chair, proximal arm weakness. The creatinine is 4.6 and CPK 1,600.