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118454 Surgery

Over the past 6 months, a 60-year-old woman with long standing duodenal ulcer disease has been complaining of anorexia, nausea, weight loss and repeated vomiting. She recognizes undigested food in the vomitus. Examination and workup reveal dehydration, hypokalemia, and hypochloremic alkalosis. What is the most likely diagnosis?

ACarcinoma of the fundus
BPenetrating ulcer
CPyloric obstruction due to cicatricial stenosis of the lumen of the duodenum
DZES (Zollinger Ellison Syndrome)
Surgery
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