Abstract：
An 85-year-old female patient presented to the emergency department with the chief complaint of sudden upper abdominal pain. The patient suffered from anorexia and epigastric pain for a month, and a local physician suspected a diagnosis of gastric ulcer. An abdominal computed tomography(CT)scan showed intraperitoneal free air as well as irregular thickening and thinning of the gastric wall. Gastric ulcer perforation was suspected, and an emergency operation was performed. Surgical findings showed thickening of the gastric wall in the pylorus and gastric corpus but partial thinning of areas of the anterior wall of the gastric corpus with a perforation measuring 5 mm. A distal gastrectomy and reconstruction were performed using the Billroth Ⅱ method. The histopathological diagnosis was malignant gastric lymphoma(diffuse large B- cell lymphoma). Considering the patient\'s age and general condition, chemotherapy was not administered after surgery. The patient was alive without recurrence 8 months after the operation.
摘要：
一名85岁的女性患者以突发性上腹痛为主要主诉来到急诊科。患者出现厌食症和上腹痛一个月,当地医生怀疑胃溃疡的诊断。腹部计算机断层扫描（CT）扫描显示腹膜内游离空气以及胃壁不规则增厚和变薄。怀疑胃溃疡穿孔,进行了紧急手术。手术结果显示，幽门和胃体的胃壁增厚，但胃体前壁区域部分变薄，穿孔为5mm。采用BillrothⅡ法进行远端胃切除术和重建。病理诊断为恶性胃淋巴瘤（弥漫性大B细胞淋巴瘤）。考虑到病人的年龄和一般情况，手术后未进行化疗.术后8个月患者存活无复发。
