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患者男性,65岁;上腹部不适或隐痛7年;突然呕吐咖啡样液体约200ml,黑便3次,约600g。吐血前曾两次胃镜检查。均提示慢性浅表性胃炎。查体:消瘦,轻度贫血貌,浅表淋巴结无肿大,腹平软上腹部偏左有轻度深压痛,未及包块,腹部透视(一)。入院胃镜检查发现:贲门下4cm小弯侧后壁一隆起性病灶约2×3cm,其中央有一凹隐性溃疡0．6×0．6cm,基底不平,边缘不规则呈锯齿样,硬而脆,触之易出血。拟诊断为:胃体部溃疡型胃癌。活检病理报告:重度慢性胃炎,萎缩(＋＋),肠
Male patient, 65 years old; upper abdominal discomfort or pain for 7 years; suddenly vomit coffee-like liquid about 200ml, black stool 3 times, about 600g. Twice before endovascular gastroscopy. All suggest chronic superficial gastritis. Examination: weight loss, mild anemia appearance, superficial lymph nodes without swelling, abdominal soft left upper abdominal mild mild tenderness, without mass, abdominal fluoroscopy (a). Admission gastroscopy found: 4cm under the cardia curved side of the posterior wall of a protuberant lesion about 2 × 3cm, the center of a concave occult ulceration 0.6 × 0.6cm, uneven base, an irregular edge was serrated, hard and brittle , Touch the easy bleeding. To be diagnosed as: gastric body ulcerative gastric cancer. Biopsy pathology report: severe chronic gastritis, atrophy (++), intestine