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GASTRITISINCHILDREN

ChongqingChildren’sHospitalDivisionofInfectiousDiseaseandGastroenterologyGastritis

AcuteGastritisChronicGastritis2AcuteGastritis3FoodandDrugs:

Severestressstate:Acuteinfection:

Corrosivesubstances:VagalstimulationAcidsecretionReleaseofvasoactiveamineandcytokinesMicrocirculationdisdurbanceGastricmucosalischemiaImpairmentofmucosalandmucousbarriersBack-diffusionofhydrogenions

Shock,hydrocephalus,suddentrauma,seriousinfection,majoroperation,etcAcute

gastritisEtiology&Pathogenesis5

ManifestationsAsuddenonsetTypicalmanifestations:epigastricpain,nausea,vomiting,waterydiarrheaFever:causedbybacterialinfectionoritstoxinsComplications:dehydration,electrolytedisturbances,acid-baseimbalance,UGIbleedingAcute

gastritisManifestations6Diagnosis

AcutesimplegastritisHistorysymptoms

and

signsGIendoscopy&Biopsy(ifnecessary)Acute

gastritis

DiffusivehyperemiaandedemaofthegastricmucosaAcuteinflammation:neutrophilicinfiltrationinthelaminapropriaMayaccompaniedwithpunctatehemorrhageandmildcorruptlesion7Chronicgastritis9Thetoptworeasonsforrecurrentabdominalpaininchildrenare

chronicgastritis

&

PUDAnestimated10%schoolagechildrenisaffectedbyrecurrentabdominalpain.10Bydefinition,isahistopathologicalentitycharacterizedbychronicinflammationofthestomachmucosa.Itmaypresentwithanarrayofsymptoms,themostcommonbeingnonspecificrecurrentabdominalpaininchildren.HighfrequencyinchildrenChronic

gastritis11EtiologyHelicobacterpylori(HP)BilerefluxDietaryHabitSequelaofacutegastritisDrugsPsychologicalandgeneticfactors:EmotionalstressChronicDiseaseOtherfactorsChronic

gastritis13HelicobacterploriChronic

gastritis14HPyloriisconsideredtoinfectvirtuallyallpatientswithchronicactivegastritisandthoughttobespreadfrompersontopersonviaoral-oraland/orfecal-oralroutes.Chronic

gastritis15Clinicalmanifestation

ArelativelyminormanifestationofdiseasesThesmallerthechildrenthemoreatypicalmanifestationChronic

gastritis17AuxiliaryexaminationsGastroscopicexaminationisthemostreliablemethodfordiagnosisofgastritisBiopsyX-ray:BariummealexaminationHPdetectionChronic

gastritis18DiagnosticmethodsofHPinfectionRapidureasetestUreabreathtest(C13)HistologySerumAntibodiestoHPBacterialCultureTestingforHPstoolantigenPolymerasechainreactionChronic

gastritis19DifferentialDiagnosisChronic

gastritisEnterositeEnterospasmAbdominalepilepsy21TreatmentEtiologictreatment:Dietaryadjustment,quitirritantdrugsorotherstimulus,HPeradication,trytocontrolthebilereflux,etcSymptomatictreatmentProtectionofgastricmucosaInhibitionofgastricacidChronic

gastritis22HPeradicationChooseonedrugbelowPPIOmeprazoleLansoprazoleBismuthpreparationBismuthSubsalicylateBasicChoosetwoantibioticsbelowAmoxicillinClarithromycinMetronidazoleFuraxoneTripleregimensChronic

gastritis23

Enhancingmucosaldefense

BismuthcompoundsSucrafate

Symptomatictreatment

AtropineBelladonnaChronic

gastritis25NormalGastricMucosaNGM26GastricLymphoidHyperplasiaNormallythereisnoorganizedlymphoidtissueinthestomach.MultiplepapulesintheantrumcorrespondingtolymphoidhyperplasiainducedbyHelicobacterpyloriinfection.

NGM29AlkalineRefluxGastritis

NormalgastricmucosaStomachmucosadiffuselycoveredwithbile-stainedmucus.

NGM30GastricCandidiasis

NormalgastricmucosaGastriccandidiasiswithextensivegreen-whiteexudatescoveringtheantrum.

31ChronicAntralGastritis

Increasedvisibilityofthe

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