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Erosive Gastritis

Aka: Erosive Gastritis, Hemorrhagic Gastritis, Multiple Gastric Erosions, Stress Ulcer

See Also
1. Dyspepsia
2. Peptic Ulcer Disease
Pathophysiology
Causes
1. Medications
2. Severe stress (mucosal protection breaks down, allows for splanchnic hypoperfusion)
  1. Burns
  2. Sepsis
  3. Trauma
  4. Surgery
  5. Shock
  6. Respiratory failure
  7. Renal Failure
  8. Liver failure
  9. Mechanical Ventilation
Symptoms (May be asymptomatic)
1. Epigastric discomfort
2. Nausea or Vomiting
3. Hematemesis
4. Melena
Signs
1. Epigastric tenderness
Diagnosis
1. Upper endoscopy (EGD)
  1. Mucosal inflammation and engorgement
  2. Erosions and hemorrhages
2. Upper GI barium study
  1. Thickened rugae
Management
1. ABC Management first
Prevention in Critically ill hospitalized patients
1. Option 1: Maintain gastric pH > 4
  1. Proton Pump Inhibitor orally or intravenously
  2. H2 Antagonist IV drip
  3. Protect against Aspiration Pneumonia
2. Option 2: Topical protectants
  1. Sucralfate (carafate) slurry 1 g PO q6h
  2. Misoprostol 200 ug PO qid
  3. Less risk of Aspiration Pneumonia than Option 1

Curling Ulcer (C0010474)
Definition (MSH)	Acute stress DUODENAL ULCER, usually observed in patients with extensive third-degree burns.
Concepts	Disease or Syndrome (T047)
MSH	D004381
SnomedCT	39755000
English	Ulcer, Curling's, Curling's Ulcer, Curlings Ulcer, ULCER, CURLINGS, ULCER, GASTROINTESTINAL, FOLLOWING BURN, Curling's ulcer, Curling ulcers, Curling Ulcer, curling ulcer, curlings ulcer, curling ulcers, curling's ulcer, curlings ulcers, Ulcer, Curling, Curling's ulcers, Curling's ulcers (disorder), Curling
Italian	Ulcera di Curling
Japanese	カーリング潰瘍, ｶｰﾘﾝｸﾞｶｲﾖｳ
Czech	Curlingův vřed
French	Ulcère de Curling
German	Curling-Ulkus
Hungarian	Curling fekély
Spanish	úlceras de Curling (trastorno), úlceras de Curling, Ulcera de Curling, Úlcera de Curling
Dutch	Curling-ulcus
Portuguese	Úlcera de Curling
Sources	Derived from the NIH UMLS (Unified Medical Language System)

Acute gastric mucosal erosion (C0267112)
Concepts	Disease or Syndrome (T047)
ICD10	K25
SnomedCT	444926003, 2367005, 18338004, 18665000, 182945005
English	Acute gastric mucosal erosion, NOS, acute erosive gastritis (diagnosis), acute erosive gastritis, Acute gastric mucosal erosion, Acute gastric erosions, erosion (acute) of stomach, Acute erosive gastritis (disorder), Acute erosive gastritis, Erosion;gastric;acute, acute gastric erosions, gastritis erosive, erosive gastritis, haemorrhagic gastritis, acute hemorrhagic gastritis, erosive gastropathy, gastritis hemorrhagic, haemorrhagic gastriti, hemorrhagic gastritis, Acute erosion of stomach, Acute gastric mucosal erosion (disorder), acute gastric erosion
Dutch	acute maagerosies
French	Erosions gastriques aiguëes
German	akute Magenerosionen
Italian	Erosioni gastriche acute
Portuguese	Erosões gástricas agudas
Spanish	Erosiones gástricas agudas, gastritis erosiva aguda, gastritis aguda erosiva, gastritis erosiva aguda (trastorno), erosión aguda de la mucosa gástrica, erosión aguda de la mucosa gástrica (trastorno), erosión mucosa gástrica aguda (trastorno), erosión mucosa gástrica aguda, erosión aguda de estómago
Japanese	急性胃粘膜びらん, ｷｭｳｾｲｲﾈﾝﾏｸﾋﾞﾗﾝ
Czech	Akutní žaludeční eroze
Hungarian	Acut gastrikus erosiók
Sources	Derived from the NIH UMLS (Unified Medical Language System)