A 55-year-old man was admitted with a 3-week history of haematemesis with abdominal and back pain. He had a background of severe alcohol related pancreatitis 5 years previously and possible gastric varices. At presentation he was shocked (pulse 127, blood pressure 94/68, lactate 7.1 mM). Haemoglobin 8.0 g/L, platelet count 447 000/|xL, liver function tests and coagulation were normal. After resuscitation and antibiotics he underwent oesophagogastroduodenoscopy in the Intensive Care Unit. Fresh blood was seen in the stomach, with thrombus adherent to an ulcer on a raised area of mucosa at the incisura (figure 1A). During therapeutic adrenaline injection, the needle was suspected of penetrating through the ulcer, and further therapy was halted.
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机译：一名55岁的男子因呕吐伴腹部和背部疼痛3周的病史入院。他在5年前患有严重的酒精相关性胰腺炎，并可能患有胃静脉曲张。在演讲中，他感到震惊（脉冲127，血压94/68，乳酸7.1 mM）。血红蛋白8.0 g / L，血小板计数447 000 / | xL，肝功能检查和凝血功能正常。进行复苏和抗生素治疗后，他在重症监护室接受了食管胃十二指肠镜检查。在胃中看到新鲜血液，血栓附着在切开处粘膜升高区域的溃疡上（图1A）。在治疗性肾上腺素注射期间，怀疑针头穿透了溃疡，并停止了进一步治疗。
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