title: Acute gastric disease after cutaneous thermal injury.
abstract: Diffuse erosive "gastritis" was discovered as early as five hours postinjury in 45 of 54 burn patients (83.5%) evaluated by gastroduodenoscopy. Acute ulcers were identified in 14 patients (26%); concomitant duodenal disease was present in 34 patients (76%). Microvascular fibrin thrombi were not demonstrated even though five patients had disseminated intravascular coagulation. Seven patients were examined before nasogastric intubation; four, with a mean burn size of 59.6% total body surface, had diffuse "gastritis." Low total serum protein levels were measured in 81% of tested patients, but were not predictive of mucosal disease. Hemorrhage followed the clinical deterioration of six patients (11.1%); one ulcer perforated. Whereas coagulation abnormalities, nasogastric intubation, and hypoproteinemia may augment mucosal injury, the morphologic and histologic examinations of the lesions suggested a primary ischemic cause resulting from the opening of submucosal shunts or local vasoconstriction.
mesh_terms: D001798:Blood Proteins / Q000032:analysis; D002056:Burns / Q000150:complications*; D004211:Disseminated Intravascular Coagulation / Q000150:complications; D004378:Duodenal Diseases / Q000175:diagnosis / Q000209:etiology; D004381:Duodenal Ulcer / Q000175:diagnosis / Q000209:etiology; D004386:Duodenum; D004724:Endoscopy; D005756:Gastritis / Q000175:diagnosis / Q000209:etiology*; D005773:Gastroscopy; D006801:Humans; D007440:Intubation; D007441:Intubation, Gastrointestinal; D008297:Male; D008887:Military Medicine; D008889:Military Personnel; D009305:Nasopharynx; D010439:Peptic Ulcer Perforation / Q000209:etiology; D012867:Skin / Q000293:injuries*; D013781:Texas
chemical_list: D001798:Blood Proteins