A Clinical Reasoning Exercise: Dysmetria, Nausea, Vomiting, Trouble to Speak

Clinical Case

A-52-year-old man with a previous diagnosis  of an esophageal carcinoma , went to the hospital with nausea, vomiting and constipation. He had no fever or abdominal pain. The physical examination showed no bowel movements. The neurologic examination showed a gait disturbance, dysmetria and  difficulty speaking properly. A nasogastric tube was inserted and a big amount of liquid was extracted from the stomach.

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