A 62-year-old man presented with an ileus, marked abdominal distention, hypotension, and oliguria. He had a 15-year history of chronic psychosis. Laboratory findings included renal dysfunction, abnormal liver-function values, and marked hyponatremia. A total of 4800 ml of fluid was aspirated with a nasogastric tube. An anteroposterior abdominal radiograph revealed a ptotic gastric fundus filled with a very large, radiopaque density (arrows). What was responsible for the findings?
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