A 86years old man, with past medical history of hypertension, ischemic cardiomyopathy and gallstones, that refused the cholecystectomy a year ago, was seen at the emergency room because dark vomiting and confusion that began two days ago, the physical examination was unremarkable, the blood tests revealed: haemoglobin 12g/L, 11.350cells/mm3 leucocytes, protein c reactive 10.58mg/L (normal value 5mg/L), normal liver function, 1.9mg/dL of creatinine and 252mg/dL of urea. The abdominal X-ray showed some hydroaereus levels in the small bowel.
