(一)、消化性溃疡并穿孔（上）

Case I:Acute Abdomen ( peptic ulcer)
Hello. I am Doctor Chen, a gastropancrcatic surgeon.
How can I help you today?你好我是陈医生，胃胰腺外科医生，我能帮你做什么？
Hello! My name is Yang. 1 am having belly pain.我叫杨，我肚子痛。
Can you tell me more about it? When did the pain
start? 你能告诉我更多哦吗，什么时候开始的？
WelI. it all started yesterday night. I started to have
pain after dinner.昨天晚上，晚饭后开始疼。
Where are you mostly feeling the pain?哪里疼
Right up here (Patient pointing to the right upper
quadrant (RUO).这里，病人指向右上象限。
Did it start all of a sudden or did you have a similar
milder pain which got worse?疼痛是突然疼起来的还是逐渐加重的？
It started all of a sudden. I was woken up by it at
night. I did have a heavy meal last night.突然痛的，我晚上被疼醒。我昨天吃了一顿大餐。
What do you feel? Can you describe the pain to me?
1s it a burning pain. a throbbing pain.or a tearing pain?你感觉怎样，能描述一下是怎样疼的吗？烧灼痛，阵痛，撕裂痛？
I think it is more of a burning pain.我感觉更多的是灼烧痛
Does the pain stay in one place or does it move to
another place?疼痛只在一个地方还是转移到其他地方？
The pain stays above my umbilical region.只在上腹部疼痛。
Have you had this kind of pain before？你之前有过这样的疼痛吗？
Yes.I can recall a few weeks back I had the same kind of pain It occurred at the same place. I woke up from sleep and I couldn't get back to bed. The pain was very intense.我记得几周前我有过一次这样的疼痛，在同样的地方。我被疼醒了之后就没睡着，疼痛相当剧烈。
And how did the pain go away? Did you take anymedications or do something to alleviate the pain?疼痛怎样停止的？你有没有吃什么药或者做什么来缓解疼痛？
P: I drank some milk and ate a piece of bread with it.
Later on. I took one mint tablet and after some time.the pain was gone.我喝了点牛奶，吃了一块面包，之后吃了一片薄荷片。疼痛就停止了。
D: So the pain subsided after you ate some bread. Have you ever had the pain after eating?所以你吃了面包后疼痛缓解，你之前有没有饭后疼痛？
P: No. Not that I can recall.我记得没有
D:Apart from pain 'n the tummy,.did you have any
associated symptoms. For example did you have any nausea, vomiting, diarrhea? Have you ever felt reflux of acid or food into your esophagus?除了腹部疼痛，有没有其他伴随症状，比如你有没有恶心，呕吐，腹泻？有没有反酸和食物返回食道？
P: I felt Iike vomitting but didn't cnd up throwing up.
I can recall once I had vomiting with some tinge of
blood in my vomitus. I was very worried about it and I went to the affiliated hospital of Southern Medical University for a check-up. I was recommended to be admitted and an endoscopy done to further investigate the cause of the blood tinge vomitus. But I have quite a busy schedule; I couldn't stay at the hospital for the procedure. I was prescribed with Omeprazole for a month. I was due for an elective upper endoscopy the next month. Sometimes I have rcgurgitation of acid in
my esophagus following consumption of spicy food
and alcohol.我想吐但是吐不出来，我记得有一次我呕吐物里有一点点血。我很担心，去南方医科大学附属医院做了检查。医生建议我住院，做胃镜来查明呕吐物中有血的原因。但是我太忙了，没有时间呆在医院。我预约了下个月做胃镜。有时候吃了辛辣食物和喝酒后，我有食道反酸。