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Gastritis, Emergency Medicine

Yanina Purim-Shem- Tov Reviewed 06/2017
 


Basics

Description

  • Inflammatory response of gastric mucosa to injury—“gastritis”

  • 3 lines of defense of gastric mucosa:

    • Mucous layer that forms protective pH gradient

    • Surface epithelial cells that can repa...

Diagnosis

Signs and Symptoms

  • Dyspepsia

  • Bloating

  • Nausea/vomiting

  • Anorexia

  • Epigastric tenderness

  • Heartburn

History

  • Dyspepsia

  • Epigastric pain or discomfort (episodic and chronic)

  • Bloating, indigestion, eructation,...

Treatment

Pre-Hospital

  • ABCs

  • IV fluid resuscitation

Initial Stabilization/Therapy

  • ABCs with acute erosive or hemorrhagic gastritis that presents with hemodynamic instability

  • IV fluid resuscitation with lact...

Follow-Up

Disposition

Admission Criteria

  • Acute hemorrhagic or erosive gastritis that presents with upper GI tract bleeding, tachycardia, and hypotension

  • Uncontrolled pain or vomiting

  • Coagulopathy from med...

Pearls and Pitfalls

  • Gastritis/gastropathy is a common presentation to ED.

  • Symptoms typically are dyspepsia, nausea, and vomiting.

  • ED management depends on patient's clinical symptoms, but should include...

Additional Reading

  • Czinn  SJ. Helicobacter pylori infection: Detection, investigation, and management. J Pediatr.  2005;146:S21–S26.

  • Eswaran  S, Roy  MA. Medical management of acid-peptic disorder...

Codes

ICD9

  • 535.00 Acute gastritis, without mention of hemorrhage

  • 535.30 Alcoholic gastritis, without mention of hemorrhage

  • 535.50 Unspecified gastritis and gastroduodenitis, without mention of hemorrhage

  • ...

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