Vomiting with weight loss

Some differential diagnoses and typical outline evidence

Oesophageal carcinoma	Suggested by: dysphagia to solid food first, then semisolid and finally fluid.
	Confirmed by: barium swallow showing filling defect, fibreoptic gastroscopy with mucosal biopsy of visible tumour.
	Management: OHCM pp508, 718.
Gastric carcinoma	Suggested by: satiety after small meal.
	Confirmed by: oesophagogastroscopy showing and allowing biopsy of visible tumour, barium meal showing filling defect.
	Management: OHCM p508.
Achalasia	Suggested by: vomiting after large meals, undigested solid food and fluid, dysphagia to fluid, nocturnal regurgitation.
	Confirmed by: barium swallow demonstrating the absence of peristaltic contractions, oesophagogastroscopy showing dilatation.
	Management: OHCM p212.
Oesophageal stricture	Suggested by: undigested solid food and fluid in vomitus.
	Confirmed by: barium swallow, oesophagogastroscopy showing food residue and fixed narrowing.
	Management: OHCM p212.
Small intestinal tumour e.g. lymphoma	Suggested by: abdominal pain, anorexia.
	Confirmed by: small bowel follow-through, CT abdomen, flexible enteroscopy with biopsy.