1. A 40-year-old male smoker presents with history of projectile non-bilious vomiting for the past..

1. A 40-year-old male smoker presents with history of projectile non-bilious vomiting for the past week. The vomitus contains residue of food items eaten previously and is foul-smelling. The vomiting is associated with bouts of severe upper abdominal colicky pain that are relieved after vomiting. He gives history of episodes of upper abdominal gnawing pain in the past. On examination, the patient is dehydrated and has a pulse rate of 100/min and a BP of 100/60 mmHg. There is distension in the epigastrium and umbilical regions with presence of a succussion splash on auscultation.