患者男,72岁。入院后经X线、CT、超声及痰培养等检查诊断为小肠气囊肿穿孔并急性腹膜炎、慢性支气管炎、肺气肿并绿脓杆菌性肺炎、慢性胆囊炎急性发作及胃溃疡。因患者衰弱、肺功能差,予以保守治疗。采用硅胶胃管持续胃肠减压,并给抗生素、静脉高营养等。胃肠减压后第3天,胃管内持续流出咖啡样液体,每日间断流出鲜血共100～250ml,上腹痛加剧。考虑为急性胃粘膜病变或胃溃疡出血,给予全血、甲氰咪胍及止血药静滴, Male patient, 72 years old. After admission by X ray, CT, ultrasound and sputum culture and other tests diagnosed as intestinal perforation and gas perforation and peritonitis, chronic bronchitis, emphysema and Pseudomonas aeruginosa pneumonia, acute episodes of chronic cholecystitis and gastric ulcer. Because of weak patients, poor lung function, to be conservative treatment. Continuous use of silica gel stomach decompression, and antibiotics, intravenous nutrition. Gastrointestinal decompression after 3 days, continuous outflow of coffee-like liquid in the stomach, the daily outflow of blood a total of 100 ~ 250ml, increased abdominal pain. Consider acute gastric mucosal lesions or gastric ulcer bleeding given whole blood, cimetidine and hemostatic intravenous infusion,