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home - Stomach - Gastritis and Gastropathy - Haemorrhagic Gastritis Written by Dr Sebastian Zeki

Haemorrhagic Gastritis

Acute hemorrhagic erosive gastropathy The hallmark of acute hemorrhagic and erosive gastropathy is the develop-ment of hemorrhagic and erosive lesions Mechanisms of Injury:The normal protective barrier (which includes secreted mucins, bicarbonate, and the epithelium itself) is disrupted.An additional specific pathogenetic factor in NSAID-induced acute hemorrhagic and erosive gastropathy is the inhibition of prostaglandin production. AcidBile acidsProteases Factors Damaging the Surface epithelium: NSAIDs.Alcohol.Bile acids.Mucosal hypoxia(burns, trauma, sepsis).Chemotherapy. Stress-related lesions (Curling's ulcers): Ulcers are: MultipleShallowMeasure 0.5 to 2.0 cm in diameterAlmost exclusively located in the corpus and fundus. Histology: Erosions may have only subtle features eg. thin, regenerative epithelium provides the only evidence for their occurrence.Inflammation is usually slight (consisting of no more than a few neutrophils) or absent. Treatment and prevention:Discontinuation of the offending agent.Antisecretory therapy-often used to limit concomitant damage from acid exposure.Prophylaxis- eg antisecretory sometimes used to prevent stress ulceration in the intensive care unit , and for those undergoing chemotherapy. Acute haemorrhagic and Erosive Gastropathy This permits acid and other luminal substances (eg. proteases and bile acids) to penetrate into the lamina propria, where they cause additional injury to the vasculature, stimulate nerves, and cause the release of histamine and other inflammatory mediators Written by Dr Sebastian Zeki

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