A simple case of peptic ulcer

I felt elated after having won an unusually tough medicine quiz. My colleagues congratulated me as the “best informed person on the campus.” In this euphoric frame of mind I went to conduct a busy medicine outpatient clinic.

One patient was a smart 15 year old girl, who was ushered in by her mother, with a referral from her primary care physician for a three month history of indigestion of progressively increasing severity. The indigestion consisted of recurrent nausea, vomiting, epigastric distress, and pain on eating. She had not responded to antacids or proton pump inhibitors, and the mosapride and ondansetron that were subsequently prescribed …