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患者男性,58岁。慢性中上腹部疼痛30年,多数呈饥饿痛,无明显周期节律性,伴反酸、暖气及上腹饱胀。近半年来,症状明显加重,上腹部持续性胀痛,纳差、恶心、消瘦。无呕血病史,近一年来有间断黑便史,量不多。检查:慢性消瘦病容,轻度贫血面貌,左上腹部压痛(+)。血常规:Hb 9.2g/L,WBC 10.8×10~9/L,N 78％,L21％,E 1％,肝、肾功能正常,大便潜血试验2次阳性。纤维胃镜检查:食道粘膜正常,胃体粘膜粗大,呈脑回状改变,肥大之粘膜明显水肿、充血,粘膜顶部广泛片状糜烂,呈地图样改变,不凹
Male patient, 58 years old. Chronic upper abdominal pain for 30 years, most hungry pain, no significant periodic rhythm, with acid reflux, heating and abdominal fullness. Nearly six months, the symptoms were significantly increased, persistent abdominal pain, anorexia, nausea, weight loss. No history of hematemesis, intermittent melatones in the past year, not much. Check: chronic wasting disease, mild anemia, upper left abdomen tenderness (+). Blood: Hb 9.2g / L, WBC 10.8 × 10 ~ 9 / L, N 78%, L21%, E 1%, liver and kidney function was normal, fecal occult blood test 2 times positive. Fiber gastroscopy: normal esophageal mucosa, mucosa of the corpus gland, showed a gyrus change, hypertrophy of the mucosa significantly edema, congestion, mucosal top extensive flake erosion, showed a pattern change, not concave