This 72 year old farmer came to the office complaining of repeated episodes of vomiting after eating. He stated that he would become full even after eating only a a small portion of his plate. This was something new. He also had a constant sensation of bloating in his abdomen and had lost 9 pounds over the last month. He was hungry - but was becoming afraid to eat because eating brought on the symptoms. He had a duodenal ulcer many years ago, but has had no ulcer symptoms for many years.
After an office evaluation, he underwent gastroscopy which showed that he had developed pyloric stenosis, or a narrowing of the "drain" that empties the stomach into the small intestine. In this photo, taken during the exam, you can see that the pyloric opening is tightly shut and is somewhat inflamed.