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患者男,69岁,农民。持续发热伴咳嗽半个月于1988年4月25日入院。体温在38～39.5℃,咳少量白粘痰、带血丝,并有上腹部钝痛,无胸痛,不吐不泻。在当地医院治疗9天无效(用药不详)。入院前两天上腹痛加重,呕吐少量浅褐色液,次日两次呕吐咖啡样液约800ml,感头晕、心慌。入院当天又呕吐稀咖啡色液约500ml,解黑便约50克。既往有反复咳嗽,咳痰病史7年。体检:体温38.2℃,脉搏110次,呼吸24次,血压13.3/10.6kPa,精神萎靡,皮肤巩膜无黄染,未扪及肿大淋巴结。两下肺较多湿罗音,心率110次,律齐,无杂音。腹软,剑突下压痛,未及包块,肝脾未
Male patient, 69 years old, farmer. Continuous fever with cough for two weeks in April 25, 1988 admission. Body temperature at 38 ~ 39.5 ℃, cough a small amount of white phlegm, bloodshot eyes, and dull upper abdominal pain, no chest pain, no spit diarrhea. 9 days in the local hospital is invalid (medication is unknown). Two days before admission, abdominal pain aggravated, vomiting a small amount of light brown liquid, vomit coffee twice a day about 800ml, feeling dizzy, palpitation. On the day of admission vomit dilute brown liquid about 500ml, about black solution is about 50 grams. Previously repeated cough, sputum history of 7 years. Physical examination: body temperature 38.2 ℃, pulse 110 times, breathing 24 times, blood pressure 13.3 / 10.6kPa, apathetic skin sclera no yellow dye, palpable enlarged lymph nodes. More lung wet rales two lungs, heart rate 110 times, law Qi, no noise. Abdomen soft, xiphoid tenderness, and mass, liver and spleen not