Acute Gastric Disease After Cutaneous Thermal Injury

MAJ Albert J. Czaja, MAJ Joseph C. Mcalhany, MAJ Willard A. Andes, COL Basil A. Pruitt

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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.

Original languageEnglish (US)
Pages (from-to)600-605
Number of pages6
JournalArchives of Surgery
Volume110
Issue number5
DOIs
StatePublished - May 1975

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ASJC Scopus subject areas

  • Surgery

Cite this

Czaja, MAJ. A. J., Mcalhany, MAJ. J. C., Andes, MAJ. W. A., & Pruitt, COL. B. A. (1975). Acute Gastric Disease After Cutaneous Thermal Injury. Archives of Surgery, 110(5), 600-605. https://doi.org/10.1001/archsurg.1975.01360110146024