重庆医科大学：《儿科学》课程教学资源（PPT课件）GASTRITIS IN CHILDREN

GASTRITIS N CHILDREN Chongqing Children's HoSpital Division of Infectious Disease and Gastroenterology N

GASTRITIS IN CHILDREN Chongqing Children’s Hospital Division of Infectious Disease and Gastroenterology

Cg Gastritis ■ Acute gastritis Chronic Gastritis

2  Gastritis ◼ Acute Gastritis ◼ Chronic Gastritis

Acute Gastritis

3 Acute Gastritis

Acute gastritis ① Diffination 2 Etiology Pathogenesis ③ Pathology

4  Diffination  Etiology & Pathogenesis  Pathology Acute gastritis

Acute gastritisEtiology&Pathogenesi Food and Drugs Severe stress state: Shock, hydrocephalus, sudden trauma, serious infection, major operation, etc Vagal stimulation Acid secretion Release of vasoactive amine and cytokines Microcirculation disturbance Gastric mucosal ischemia Impairment of mucosal and mucous barriers Back-diffusion of hydrogen ions Acute infection: Corrosive substances

5  Food and Drugs:  Severe stress state:  Acute infection:  Corrosive substances: Vagal stimulation Acid secretion Release of vasoactive amine and cytokines Microcirculation disdurbance Gastric mucosal ischemia Impairment of mucosal and mucous barriers Back-diffusion of hydrogen ions Shock, hydrocephalus, sudden trauma, serious infection, major operation, etc Acute gastritis Etiology & Pathogenesis

Acute gastritisManifestations ④ Manifestations A sudden onset ypIcal manIfestations. epigastric pain nausea, vomiting, watery diarrhea Fever: caused by bacterial infection or its toxins Complications: dehydration, electrolyte disturbances, acid-base imbalance. UGI bleeding

6 ④ Manifestations ▪ A sudden onset ▪ Typical manifestations: epigastric pain, nausea, vomiting, watery diarrhea ▪ Fever: caused by bacterial infection or its toxins ▪ Complications: dehydration, electrolyte disturbances, acid-base imbalance, UGI bleeding Acute gastritis Manifestations

Acute gastritis ⑤ Diagnosis Cg Acute simple gastritis History symptoms and signs GI endoscopy Biopsy (if necessary) t Diffusive hyperemia and edema of the gastric mucosa +Acute inflammation neutrophilic infiltration in the lamina propria May accompanied with punctate hemorrhage and mild corrupt lesion

7 ⑤ Diagnosis  Acute simple gastritis History symptoms and signs GI endoscopy & Biopsy (if necessary) Acute gastritis  Diffusive hyperemia and edema of the gastric mucosa  Acute inflammation: neutrophilic infiltration in the lamina propria  May accompanied with punctate hemorrhage and mild corrupt lesion

Acute gastritis 6 Treatment A Remove of offending agents Quit all irritants or stimulus: drugs, alcohol Management of the original diseases B Symptomatic treatment 1)Replacement of fluid and electrolyte loss 2)Spasmolysant: Atropine, Belladonna 4)Antiemetic drugs: Domperidone 3)Special management for upper Gl bleeding C. Protection of gastric mucosa and inhibition of gastric acid Mucosal protector Antacids: H2-RA PPl

8 A. Remove of offending agents Quit all irritants or stimulus: drugs, alcohol Management of the original diseases B. Symptomatic treatment 1)Replacement of fluid and electrolyte loss 2)Spasmolysant: Atropine, Belladonna 4)Antiemetic drugs: Domperidone 3)Special management for upper GI bleeding C. Protection of gastric mucosa and inhibition of gastric acid Mucosal protector Antacids: H2-RA, PPI ⑥ Treatment Acute gastritis

Chronic gastritis

9 Chronic gastritis

An estimated 10% school age children is affected by recurrent abdominal pain The top two reasons for recurrent abdominal pain in children are chronic gastritis PUD 10

10 The top two reasons for recurrent abdominal pain in children are chronic gastritis & PUD An estimated 10% school age children is affected by recurrent abdominal pain