Description
A 49 year old man had ten emergency admissions over 27 years for recurrent acute abdominal pain. His first admission at the age of 22 was precipitated by a 24 hr history of acute abdominal pain and nausea. Physical examination was normal. As the patient had a splenectomy 4 years previously following a road traffic accident, a working diagnosis of sub acute intestinal obstruction due to adhesions was made. The symptoms resolved spontaneously after 24 hours without any active medical intervention. Biochemical investigations including serum amylase, electrolytes, liver function tests, calcium, were normal as was a urinary porphobilinogen screen.
