Acute Gastritis

Description:
Focal damage to gastric mucosa. Also called acute erosive gastritis, gastric erosion, acute hemorrhagic gastritis, stress ulcers.

Causes:

• Aspirin (NSAIDs)
• Ethanol
• Aalkali and acid
• Ischemia
• Steroids, cigarettes, pancreatic enzymes, bile acids
• Severe stress such as sepsis, severe trauma and burns.

Physical Findings:

Often normal, GI bleeding, tachycardia, hypotension, pallor and upper abdominal tenderness.

Diagnosis:

1. Endoscopy shows congestion, friability, superficial ulceration, petechiae, black hemorrhagic areas are superficial erosions
2. Blood in gastric aspirate

Treatment:

1. Antacids, H2 blockers, sucralfate, omeprazoleprochlorperazine for treating uncomplicated nausea and vomiting.
2. For massive bleeding give vasopressin IV or intra-arteriorly to mesenteric artery; contraindicated in coronary artery disease; only temporary treatment.
3. Near-total gastrectomy if uncontrolled bleeding