TY - CHAP M1 - Book, Section TI - See a doctor, support a lawyer A1 - Murtagh AO, John A1 - Bird, Sara PY - 2019 T2 - Murtagh's Cautionary Tales, 3rd Edition AB - Long ago, during my term as a surgical registrar I was asked to see a rather rugged 65-year-old farmer with chronic intermittent abdominal pain. The problem was puzzling the Resident Medical Officer (RMO), especially as the patient had the ‘thick file’ syndrome. He was a rather likeable phlegmatic man who seemed to have a genuine problem and was embarrassed by his occasional visits to various doctors and the emergency department. He described the pain, which was located centrally, as colicky, mild to moderate and dull. It was associated with mild abdominal distension, nausea (no vomiting) and constipation with hard, pellet-like stools. Diagnoses that had been suggested were irritable bowel syndrome and/or abdominal adhesions. He said that the painful attacks which simply felt like ‘a kick in the guts’ would dissipate as quickly as they came. He had a history of a cholecystectomy 21 years previously. SN - PB - McGraw-Hill Education (Australia) Pty Ltd CY - Sydney, Australia Y2 - 2024/03/28 UR - murtagh.mhmedical.com/content.aspx?aid=1163949173 ER -