Table of Contents
Definition / general | Etiology | Gross images | Microscopic (histologic) description | Microscopic (histologic) imagesCite this page: Weisenberg E. Acute gastritis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/stomachacutegastritis.html. Accessed January 18th, 2021.
Definition / general
- 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
Etiology
- Mucosal damage due to increased acid secretion with back diffusion into mucosa, decreased bicarbonate buffer, reduced blood flow, disruption of mucous layer
Microscopic (histologic) description
- 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