Home   Chapter Home   Jobs   Conferences   Fellowships   Books




Erosive (acute hemorrhagic) gastritis

Reviewers: Elliot Weisenberg, M.D. (see Reviewers page)
Revised: 12 November 2012, last major update July 2012
Copyright: (c) 2003-2012, PathologyOutlines.com, Inc.


● Acute mucosal inflammatory process, usually transient (normal stomach has only rare inflammatory cells)
● Erosion: loss of superficial epithelium above muscularis mucosa, accompanied by hemorrhage
● Variable changes include acute inflammatory infiltrate, extrusion of fibrinopurulent exudate into lumen, mucosal sloughing, regenerative changes in nearby epithelium
● Severe erosive disease may cause acute GI bleeds
● 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
● Major cause of massive hematemesis in alcoholics
● Occurs in 25% taking daily aspirin for rheumatoid arthritis; 20% of these develop overt bleeding; may be fatal in up to 5%
● Severe disease may progress to acute gastric ulcers
● Treatment with proton pump inhibitors reduces severity of mucosal damage and facilitates healing


● None; also pain, nausea and vomiting


● Mucosal damage due to increased acid secretion with back diffusion into mucosa, decreased bicarbonate buffer, reduced blood flow, disruption of mucous layer

Gross images

Various images

Micro description

● Mild: modest edema of lamina propria, vascular congestion, intact epithelium, scattered neutrophils, and hemorrhage in mucosa, erosions with more severe disease

Micro images

Acute gastritis

End of Stomach > Gastritis > Erosive (acute hemorrhagic) gastritis

This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.

All information on this website is protected by copyright of PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at [email protected] with any questions (click here for other contact information).