患者女,72岁。1998年11月1日无明显诱因出现上腹部持续性痛,午后疼痛加剧,并放射至腰背部,频发呕吐,呕出物呈咖啡色,量不多。伴畏寒,未排便。于病后第二天收住院。既往有溃疡病史,查体:体温38℃,脉搏70次/分,血压13/8kPa,急性痛苦面容,喜右侧卧位,心肺(—),腹稍膨隆,上腹部压痛明显,移动性浊音(+),肠鸣音减弱。辅助检查:白细胞 Female patient, 72 years old. November 1, 1998 no obvious incentive for persistent pain in the upper abdomen, pain intensified in the afternoon and radiate to the back and back, frequent vomiting, vomit was brown, not much. With chills, no bowel movement. The day after the illness admitted to hospital. Past history of ulcer, physical examination: body temperature 38 ℃, pulse 70 beats / min, blood pressure 13 / 8kPa, acute pain face, hi right lateral decubitus, cardiopulmonary (-), slightly bulging abdominal, abdominal tenderness, (+), Bowel sounds weakened. Auxiliary examination: white blood cells