Erosive gastritis

Topic Completed: 1 July 2012

Minor changes: 31 August 2020

Copyright: 2003-2021,, Inc.

PubMed Search: acute hemorrhagic gastritis

Elliot Weisenberg, M.D.
Page views in 2020: 4,982
Page views in 2021 to date: 6,199
Cite this page: Weisenberg E. Erosive gastritis. website. Accessed December 6th, 2021.
Definition / general
  • 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
  • Symptoms: none; also pain, nausea and vomiting
  • Physiology: mucosal damage due to increased acid secretion with back diffusion into mucosa, decreased bicarbonate buffer, reduced blood flow, disruption of mucous layer
Gross images

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Various images

Microscopic (histologic) description
  • Mild: modest edema of lamina propria, vascular congestion, intact epithelium, scattered neutrophils, and hemorrhage in mucosa, erosions with more severe disease
Microscopic (histologic) images

Images hosted on other servers:

Acute gastritis

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