病例资料患者,男,64岁。主因上腹部胀满不适伴恶心、呕吐20+d入院。既往体健,患者1年前曾因“黑便”以“上消化道出血”在外院治疗,当时行胃镜检查,未见占位性病变。20 d前无明显诱因出现上腹部剑突下饱胀不适,进食量过多或者进食速度过快时上述症状加重,伴恶心、呕吐,无呕血、黑便等。行胃镜及病理检查提示:距门齿42～50 cm胃底低分化腺癌。心电图、心脏彩超均提示心包转位。上消化道造影显示:胃底贲门癌,内脏转位(图1、2)。胸腹部CT:贲门胃底壁增厚,考虑胃底贲门癌,胸腹腔 Case information patient, male, 64 years old. The main abdominal distention due to discomfort associated with nausea, vomiting 20 + d admission. Past physical health, patients a year ago because of “black will ” to “upper gastrointestinal bleeding ” in the hospital treatment, then endoscopy, no space-occupying lesions. 20 d before no obvious incentive to appear on the fullness of the upper abdomen xiphoid discomfort, eating too much or eating too fast when the above symptoms aggravated, with nausea, vomiting, no hematemesis, melena and so on. Gastroscopy and pathological examination prompted: away from incisors 42 ~ 50 cm gastric poorly differentiated adenocarcinoma. ECG, echocardiography are prompted pericardial transposition. Upper gastrointestinal angiography showed: gastric cardia cancer, visceral transposition (Figure 1,2). Chest and abdomen CT: gastric cardia stomach thickening, consider the gastric cardia, chest and abdominal cavity