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患者女性,41岁。无明显诱因黑便20天伴上腹部阵发性隐痛,间断头晕、气短、恶心呕吐4天。查体:贫血貌,腹部脐周有轻压痛,无反跳痛,未触及包块,肠鸣音4次/分。余脏器未见异常。血常规:红细胞2.2×1012/L,血红蛋白67 g/L。大便潜血(+)。胃镜检查显示胃黏膜光滑,胃窦充血、水肿明显,部分区域呈花斑样;十二指肠球腔变形,左侧壁可见黏膜隆起,大小3 cm×2.5 cm×1.5 cm,质软,中央可见凹陷性溃疡,周边黏膜粗糙,肠腔狭窄。活检病理诊断:黏膜慢性炎症。腹部CT示十二指肠肠壁增厚,胸腹部及盆腔
Female patient, 41 years old. No obvious incentive to black for 20 days accompanied by paroxysmal abdominal pain, intermittent dizziness, shortness of breath, nausea and vomiting for 4 days. Physical examination: anemia appearance, mild abdominal tenderness on the umbilical cord, no rebound tenderness, did not touch the mass, bowel sounds 4 times / min. No abnormal organs. Blood: red blood cells 2.2 × 1012 / L, hemoglobin 67 g / L. Fecal occult blood (+). Gastroscopy showed a smooth gastric mucosa, congestion of gastric antrum, obvious edema, and some areas showed a pattern of speckles. The duodenal cavity was deformed and mucosal swelling was visible on the left side wall. The size was 3 cm × 2.5 cm × 1.5 cm, Depression of visible ulcers, peripheral mucosal rough, narrow intestine. Biopsy pathological diagnosis: chronic mucosal inflammation. Abdominal CT showed duodenal wall thickening, chest and abdomen and pelvic