Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 5 August 2012, last major update August 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.
● Includes acute hemorrhage and acute erosive gastritis
● Acute mucosal inflammatory process, usually transient (normal stomach has only rare inflammatory cells)
● Associated with heavy use of NSAIDs (non-steroidal anti-inflammatory drugs, including aspirin), excessive alcohol use, heavy smoking, cancer chemotherapy, bile reflux, uremia, systemic infections (Salmonella), severe stress (trauma, burns, surgery), ischemia and shock, acid/alkali ingestion as part of suicide attempts, gastric irradiation or freezing, mechanical trauma (nasogastric tube), distal gastrectomy
● Symptoms: none; or pain, nausea and vomiting
● May be accompanied by local hemorrhage or mucosal sloughing
● Severe erosive disease may cause acute GI bleed, acute gastric ulcer
● Major cause of massive hematemesis in alcoholics
● Occurs in 25% of those who take daily aspirin for rheumatoid arthritis
● 20% develop overt bleeding; fatal in up to 5%
● Treatment: proton pump inhibitors reduce severity of mucosal damage and facilitate healing
● Mucosal damage due to increased acid secretion with back diffusion into mucosa, decreased bicarbonate buffer, reduced blood flow, disruption of mucous layer
● Mild: modest edema of lamina propria, vascular congestion, intact epithelium, scattered neutrophils, and hemorrhage in mucosa, erosions with more severe disease
● Moderate/severe: loss of superficial epithelium above muscularis mucosa, accompanied by hemorrhage and variable acute inflammatory infiltrate and extrusion of a fibrinopurulent exudate into the lumen, nearby epithelium may show regenerative changes
End of Stomach > Gastritis > Acute gastritis
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