A 95-year-old woman was referred with a 3-week history of vomiting undigested food, abdominal pains and half a stone weight loss. The general practitioner reported a palpable epigastric mass, which was a ‘golf ball size’. She was managing fluids normally but had reduced appetite. She had a perforated duodenal ulcer repair 40 years previously and was taking aspirin and lactulose. She was otherwise living alone and independent. Apart from a normocytic anaemia …