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患者,男46岁。以发作性上腹痛3年加重1周入院。曾做钡餐检查提示“十二指肠球部变形”。1周前因劳累上述症状加重,伴纳差反酸,疼痛节律性消失。查体见上腹剑突下偏左处有轻度压痛,余未见异常。胃镜检查见胃角胃窦有散在绿豆大小糜烂境界不清,尤以胃窦小弯侧更明显。近幽门后壁有一条粗大皱襞。球部前壁有一0.7cm~2溃疡,盖有少许乳白色苔,周围粘膜充血水肿。胃镜诊断:①十二指肠球部溃疡(活动期);②慢性萎缩性胃炎伴糜烂,早癌待排。病理报告:胃窦小弯侧糜烂面的3块粘膜组织为慢性中度萎缩性
The patient, 46 years old. An episode of epigastric pain was aggravated in 3 years and admitted to the hospital one week later. Did barium meal examination prompted “duodenal ball deformation.” One week ago, due to the above symptoms of fatigue, accompany analgesia and acid reflux, pain rhythm disappeared. Check the body see the upper abdomen xiphoid slightly left tenderness, no exception. Gastroscopy showed gastric antrum scattered in the size of the mung bean erosion is not clear, especially in the smaller side of the antrum more obvious. Near the pylorus there is a thick fold. There is a 0.7cm~2 ulcer on the anterior wall of the bulb, covered with a little milky white moss, and the surrounding mucosa is congested and edema. Endoscopic diagnosis: 1 duodenal ulcer (active period); 2 chronic atrophic gastritis with erosion, early cancer to be discharged. Pathology report: Three mucosal tissues of the antero-posterior erosive surface of the antrum were chronically atrophic