This 84 year old lady presented to me last week with complaints of epigastric pain and reflux. She had actually been hospitalized several times over the past year for similar symptoms. In addition, she was hospitalized last summer for an episode of melena and anemia which, after an extensive work-up, was deemed to be secondary to gastritis. For an 84 yo lady, she was pretty sharp and pleasant. History of hypertension, controlled with lisinopril and atenolol. She also had a severe case of scoliosis, rendering her wheelchair-bound. Here's a couple cool CT slices:
Any ideas on diagnosis? Approach and kind of repair?