Case 33-1981: A 54-Year-Old Woman with Postprandial Abdominal Pain and Diarrhea

Presentation of Case First admission . A 54-year-old woman was admitted to the hospital because of abdominal pain. She was well until seven months earlier, when periumbilical pain developed and was ascribed to nephrolithiasis. The pain soon subsided but recurred four months before admission and was particularly evident 20 to 30 minutes after eating. Diarrhea and back pain developed. The patient was admitted to another hospital. The erythrocyte sedimentation rate was 76 mm per hour. Serum immunoelectrophoresis showed that IgM was 485 mg per 100 ml, and the complement 320 U. A culture of urine yielded Escherichia coli . A . . .