患儿,男,12岁,住院号30166,以规律性饥饿痛月余,黑便3天,以十二指肠溃疡病入院,全身检查除贫血外无特殊,胃镜检查见十二指肠球部充血、水肿,前壁小弯侧有一直径1.5cm 园形溃疡,溃疡周围充血水肿,投以甲氰咪呱,硫糖铝口服,数日后腹痛明显减轻,继续治疗至大便潜血阴转后出院。出院周余再次腹痛、腹胀、呕吐咖啡色胃内容物再次入院,入院次日呕血约200ml,重复原治疗,并输血800ml,病情逐渐稳定。一月后,突然上腹剧痛,呈刀割样,剑突下压痛明显,全腹肌紧张并有反跳痛,X 线检查见膈下游离气体,疑消化道穿孔,急诊手术探查,见十二指肠球部前壁有2×2cm 大小溃疡,中心约绿豆大小穿孔,穿孔周围有脓苔附 Children, male, 12 years old, hospitalization 30166, with regular hunger more than a month, black stool for 3 days to duodenal ulcer disease admission, systemic examination except for anemia no special gastroscopy see duodenal bulb Ministry of congestion, edema, a small curvature of the anterior wall of a 1.5cm diameter park-shaped ulcers, congestion and edema around the ulcer cast vote cimetidine, sucralfate orally, a few days after the abdominal pain was significantly reduced, to continue treatment to stool occult blood Yin discharged after discharge . Discharged again abdominal pain, bloating, vomiting brown stomach content again hospitalized, admitted to the hospital the next day about 200ml vomiting, repeat the original treatment, and blood transfusion 800ml, the condition gradually stabilized. After January, a sudden abdominal pain, was a knife-like, under the xiphoid tenderness significantly, the whole abdominal muscle tension and rebound tenderness, X-ray examination to see the free gas under the diaphragm, suspected digestive tract perforation, emergency surgical exploration, see Duodenal anterior wall of 2 × 2cm size ulcer, the center of about the size of mung bean perforation, perforation around the pus moss attached