acute corrosive gastritis
Introduction
Introduction to acute corrosive gastritis Acute corrosive gastritis (acutecorrosivegastritis) is caused by self-service or accidental application of strong acid (such as sulfuric acid, hydrochloric acid, nitric acid, acetic acid, tosu) or strong alkali (such as sodium hydroxide, potassium hydroxide) and other corrosive agents, causing degeneration of gastric mucosa, Erosion, ulceration or necrotizing lesions, early clinical manifestations of severe pain in the posterior sternum and upper abdomen, severe bleeding or perforation, and advanced esophageal stricture. basic knowledge The proportion of illness: 0.34% Susceptible people: no specific population Mode of infection: non-infectious Complications: peritonitis atrophic gastritis
Cause
Causes of acute corrosive gastritis
(1) Causes of the disease
This disease is caused by accidental or intentional swallowing of corrosive agents (strong bases such as caustic, strong acids such as hydrochloric acid, sulfuric acid, nitric acid, carbolic acid, tosu), the extent and depth of damage and the nature of corrosive agents, concentration and The amount, the time the etchant is in contact with the gastrointestinal tract and the amount of food contained in the stomach.
(two) pathogenesis
Concentrated acid can dissolve or coagulate protein and keratin, tissue has obvious burns or coagulative necrosis accompanied by eschar, necrotic tissue shedding can cause secondary gastric perforation, peritonitis; strong alkali absorbs tissue after contact with tissue Moisture, and combined with tissue protein into a jelly-like alkaline protein, combined with fatty acids into soap salts, causing severe tissue necrosis, often producing full-thickness of the esophageal wall and stomach wall, and even causing bleeding or perforation, both Both can cause scar formation and stenosis.
Prevention
Acute corrosive gastritis prevention
Strengthen the management of food hygiene, eliminate flies, note personal hygiene, do not overeating and use drugs that damage the gastric mucosa, diagnose them promptly after treatment, promptly treat, combine treatment, and support rehabilitation.
Complication
Acute corrosive gastritis complications Complications, peritonitis, atrophic gastritis
1, severe cases may have acute ulcers, gastric wall necrosis or even perforation caused by peritonitis.
2, in the late acute stage, the esophagus can be gradually formed, the door or pyloric scar narrow, and atrophic gastritis can be formed.
Symptom
Acute corrosive gastritis symptoms Common symptoms Shock collapse of peritonitis severe pain nausea pyloric scarring biliary reflux edema internal bleeding
After swallowing the corrosive agent, the earliest symptoms are severe pain in the mouth, throat, sternum and mid-upper abdomen, often accompanied by swallowing pain, difficulty in swallowing, frequent nausea and vomiting, and only mild congestion and edema in the stomach. Erosion, often intramucosal hemorrhage; severe cases may have acute ulcers, gastric wall necrosis or even perforation caused peritonitis, severe cases can vomit blood, vomiting bleeding mucosal rot, patients may collapse or shock, severe cases may have esophageal or gastric perforation symptoms After the lips, mouth and throat mucous membranes are in contact with the corrosive agent, they can produce different colors of burning. For example, black sputum after contact with sulfuric acid, grayish brown sulphuric acid, dark yellow sputum of nitric acid, white sputum of acetic acid or oxalic acid, strong Alkali is transparent edema of the mucous membrane. Therefore, special attention should be paid to observing the color change of the oral mucosa to help identify various corrosive poisoning.
In the acute stage, the esophagus can be gradually formed, and the stenosis or pyloric scar can be narrowed, and atrophic gastritis can be formed.
Examine
Examination of acute corrosive gastritis
Chemically identify residual etchants or vomits and develop targeted treatment options.
X-ray inspection
In the acute phase, it is generally not suitable for upper digestive tract barium meal examination, so as to avoid esophageal and gastric perforation. After the acute phase, barium meal examination can understand whether the gastric antrum mucosa is rough or not, whether the stomach cavity is deformed, whether the esophagus is narrow or not, and the stomach can be understood. The degree of sinus stenosis or pyloric obstruction can be swallowed by iodine angiography when the patient can only swallow fluid.
2. Gastroscopic examination
Early absolute contraindications for gastroscopy; if the patient can enter the fluid or semi-liquid, the gastroscope can be carefully performed to understand the esophagus and antrum, pyloric stenosis or obstruction, such as high esophageal stricture, when the gastroscope cannot pass, should not be rigid Insert to avoid perforation.
Diagnosis
Diagnosis and diagnosis of acute corrosive gastritis
diagnosis
Can be confirmed by clinical manifestations, X-ray examination, gastroscopy.
Differential diagnosis
It should be differentiated from early acute appendicitis, acute cholecystitis, acute pancreatitis, etc. Endoscopy is helpful for diagnosis and differential diagnosis.
1, acute appendicitis
In the early stage of the disease, there may be upper abdominal pain, nausea, and vomiting. However, as the disease progresses, the pain gradually turns to the right lower abdomen, and there is fixed tenderness and rebound tenderness, accompanied by fever, increased white blood cells, and increased neutrophils.
2, cholecystitis, cholelithiasis
Repeated episodes of abdominal pain, often in the right upper abdomen, can be radiated to the right shoulder, back, check the sclera, skin jaundice, right upper abdomen tenderness, Mo Fei's sign positive, or can touch the enlarged gallbladder, blood gallbladder Quantitative red matter, urinary tricholinal test is helpful for diagnosis. Fourth, other lobar pneumonia, myocardial infarction and other early stages of the disease may have different degrees of abdominal pain, nausea, vomiting, such as detailed medical history, physical examination and necessary auxiliary examination, Not difficult to identify.
