儿童胃炎GASTRITIS IN CHILDREN(英文课件).ppt

A 5-year-old girl Thief complain: vomited 5 times for 3 hours. What history of present illness do you want to know? * GASTRITIS IN CHILDREN Dr. Liu Chonghai * Gastritis Acute Gastritis Chronic Gastritis * Acute Gastritis * 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 * 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 * Normal Gastric Mucosa NGM * gastric mucosal edema NGM * Hemorrhagic gastritis Hemorrhagic gastritis with multiple intramural bleeding spots NGM * 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 Treatment Acute gastritis * Chronic gastritis * 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. * By definition, is a histopathological entity characterized by chronic inflammation of the stomach mucosa. It may present with an array of symptoms, the most common being nonspecific recurrent abdominal pain in children. High frequency in children Chronic gastritis * Classification Non-atrophic(Superficial):90-95% Chronic Gastritis Atrophic S