1.病例介绍主诉:腹上区和脐区疼痛10d。患者男,65岁。因腹上区和脐区疼痛10d,于2011年12月24日入院。患者30余年前因消化道溃疡于外院行胃大部切除术。此次上腹呈持续性闷痛,伴阵发性加重,解黑便,伴纳差,无恶心、呕吐,体质量减轻约5kg。外院胃镜检查:胃体巨大溃疡,中央覆污苔,周围组织充血,吻合口黏膜水肿。初步诊断:残胃癌。病理检查:残胃低分化腺癌。体格检查:腹部平坦,中上腹见一长约15cm手术切口瘢 1. Case Presentation Chief complaint: abdominal area and umbilical pain 10d. Male patient, 65 years old. Due to abdominal area and umbilical pain 10d, on December 24, 2011 admission. More than 30 years ago, patients with gastric ulcer in the external gastrectomy. The upper abdomen was persistent nausea pain, with paroxysmal aggravating, solution melena, with anorexia, no nausea, vomiting, weight loss of about 5kg. Outside the hospital gastroscopy: gastric ulcer, the central fouling moss around the congestion, anastomotic mucosal edema. Preliminary diagnosis: residual gastric cancer. Pathological examination: residual gastric poorly differentiated adenocarcinoma. Physical examination: flat belly, see a long 15cm surgical incision scar