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1、GASTRITISINCHILDRENChongqingChildren’sHospitalDivisionofInfectiousDiseaseandGastroenterologyGastritisAcuteGastritisChronicGastritis2AcuteGastritis3DiffinationEtiology&PathogenesisPathologyAcutegastritis4FoodandDrugs:Severestressstate:Acuteinfection:Corrosivesubs
2、tances:VagalstimulationAcidsecretionReleaseofvasoactiveamineandcytokinesMicrocirculationdisdurbanceGastricmucosalischemiaImpairmentofmucosalandmucousbarriersBack-diffusionofhydrogenionsShock,hydrocephalus,suddentrauma,seriousinfection,majoroperation,etcAcutegast
3、ritisEtiology&Pathogenesis5ManifestationsAsuddenonsetTypicalmanifestations:epigastricpain,nausea,vomiting,waterydiarrheaFever:causedbybacterialinfectionoritstoxinsComplications:dehydration,electrolytedisturbances,acid-baseimbalance,UGIbleedingAcutegastritisManif
4、estations6DiagnosisAcutesimplegastritisHistorysymptomsandsignsGIendoscopy&Biopsy(ifnecessary)AcutegastritisDiffusivehyperemiaandedemaofthegastricmucosaAcuteinflammation:neutrophilicinfiltrationinthelaminapropriaMayaccompaniedwithpunctatehemorrhageandmildcorruptl
5、esion7A.RemoveofoffendingagentsQuitallirritantsorstimulus:drugs,alcoholManagementoftheoriginaldiseasesB.Symptomatictreatment1)Replacementoffluidandelectrolyteloss2)Spasmolysant:Atropine,Belladonna4)Antiemeticdrugs:Domperidone3)SpecialmanagementforupperGIbleeding
6、C.ProtectionofgastricmucosaandinhibitionofgastricacidMucosalprotectorAntacids:H2-RA,PPITreatmentAcutegastritis8Chronicgastritis9Thetoptworeasonsforrecurrentabdominalpaininchildrenarechronicgastritis&PUDAnestimated10%schoolagechildrenisaffectedbyrecurrentabdomina
7、lpain.10Bydefinition,isahistopathologicalentitycharacterizedbychronicinflammationofthestomachmucosa.Itmaypresentwithanarrayofsymptoms,themostcommonbeingnonspecificrecurrentabdominalpaininchildren.HighfrequencyinchildrenChronicgastritis11ClassificationUpdateSydne
8、ySystemin1996SuperficialChronicGastritisAtrophicSpecifictypesChronicgastritis12EtiologyHelicobacterpylori(HP)BilerefluxDietaryHabitSequelaofacutegastritisDrugsPsychol