Old indolent ulcer and gastric fistula case reportjejunum.docVIP

 PAGE \* MERGEFORMAT 4 Old indolent ulcer and gastric fistula case reportjejunum [Keywords:] Aged, painless ulcer, gastrointestinal fistula 1. Case Introduction Female patient, 60 years old, because of intermittent vomiting, melena 1 week was admitted to hospital due to a cold one day taking the private prosecution, “anti-inflammatory drugs” (anti-inflammatory pain after vomiting, vomiting of gastric contents, no vomiting, and melena times, no abdominal pain, diarrhea. checkup: P 79 beats / min, BP 140/70 mmHg, weight loss, anemia appearance, superficial lymph node enlargement, no abnormal heart and lung, abdomen soft, non-gastrointestinal-type, no enlargement of liver and spleen, epigastric tenderness, no rebound tenderness, no palpable mass, normal bowel sounds. Laboratory: WBC 14.0 109 / L, Gran% 78.6, RBC 2.12 1012 / L, Hb 52 g / L, HCT 14.7% , fecal occult blood test (+), red blood cells (+++)/ HP, liver function: total albumin 53.8 g / L, albumin 28.8 g / L, normal renal function and no abnormal B-abdominal, upper gastrointestinal barium meal : no filling defect in the stomach cavity and Kanying, pyloric opening is good, barium through the good, no abnormal channels, endoscopy showed: Helicobacter see anterior lesser curvature of about 3.0 2.0 cm ulcer, ulcers, there was a central 1.0 0.8 cm fistula, fistula smooth edges, texture tend to be hard, into the fistula, see the circular smooth folds, pyloric opening duo, duodenum were normal. pathology: 1. ulcer disease, 2. chronic active gastritis and HP ( +). Conclusions: H. pylori huge ulcer and anterior gastrojejunostomy leak. transfusions given after admission, omeprazole 20 mg intravenous infusion needle 1 time / day, amoxicillin 750 mg Bid, berberine tablets 200 mg Bid , Franc Sidel Granules 100 mg Qid 7 days, the patient vomiting disappeared, review fecal occult blood test (-, because of financial difficulties, the patient did not receive surgical treatment, left the hospital, hospital to t