Acute corrosive gastritis

　　This condition is caused by acute gastric wall injury due to accidental ingestion or intentional swallowing of corrosive agents (such as strong alkalis like caustic soda, and strong acids like hydrochloric acid, sulfuric acid, nitric acid, and phenol). The extent and depth of the injury are related to the nature, concentration, and quantity of the corrosive agent, the duration of contact between the corrosive agent and the gastrointestinal tract, and the amount of food in the stomach.

　　1. In severe cases, there may be acute ulcers, necrosis of the gastric wall, or even perforation causing peritonitis.
　　2. In the late acute stage, esophageal or pyloric scar stenosis can gradually form, and esophageal stenosis or atrophic gastritis can also form.

　　The earliest symptoms after swallowing corrosive agents are severe pain in the mouth, throat, behind the sternum, and the upper middle abdomen. It is often accompanied by swallowing pain, difficulty swallowing, frequent nausea and vomiting. In mild cases, the gastric lesions may only show congestion, edema, and erosion, with mucosal bleeding; in severe cases, there may be acute ulcers, necrosis of the gastric wall, or even perforation causing peritonitis; in severe cases, blood vomiting may occur, vomiting blood-like mucosal slabs, and the patient may experience fainting or shock.
　　After contact with corrosive agents, the mucous membranes of the lips, mouth, and throat can produce scabs of different colors. Therefore, it is necessary to pay special attention to the color changes of the oral mucosa to help differentiate various corrosive agent intoxications. In the late acute stage, esophageal or pyloric scar stenosis can gradually form, and atrophic gastritis can also form.

　　Acute corrosive gastritis is mainly caused by damage to the gastric mucosa due to exogenous and endogenous stimulating factors, leading to acute gastritis. Therefore, it is necessary to avoid the effects of these two factors as much as possible in daily life, pay attention to dietary hygiene, and avoid overeating, eating unclean food, excessive alcohol consumption, and taking irritant drugs. In addition, enough attention should be paid to the primary diseases that can produce endogenous stimulating factors, and they should be treated and cleared thoroughly.
　　Acute gastritis is mainly caused by damage to the gastric mucosa due to exogenous and endogenous stimulating factors. Therefore, it is necessary to avoid the effects of these two factors in daily life as much as possible, pay attention to dietary hygiene, and avoid overeating, eating unclean food, excessive alcohol consumption, and taking irritant drugs. In addition, enough attention should be paid to the primary diseases that can produce endogenous stimulating factors, and they should be treated and cleared thoroughly.

　　1. X-ray examination
　　It is generally not advisable to perform an upper gastrointestinal barium meal examination during the acute stage to avoid causing esophageal and gastric perforation; after the acute stage, barium meal examination can understand whether the gastric antrum mucosa is rough, whether the gastric cavity is deformed, whether the esophagus is stenosed, and also understand the degree of stenosis of the gastric antrum or pyloric obstruction; in the late stage, if the patient can only swallow liquid, they can swallow iodine water for contrast examination.

　　2. Endoscopy
　　Early-stage absolute禁忌endoscopy; in the late stage, if the patient can consume liquid or semi-liquid foods, endoscopy can be done cautiously to understand whether there is stenosis or obstruction in the esophagus and gastric antrum, and the pylorus. If the esophagus is highly stenosed and the endoscope cannot pass through, it should not be inserted forcibly to avoid perforation.

　　Drink plenty of water to replenish the water and salt lost due to vomiting and diarrhea. Generally, drink 150-200 milliliters per hour. Drinking plenty of water is also beneficial for excreting toxins.

　　After the patient stops vomiting and the frequency of diarrhea decreases, they should drink a small amount of millet congee or thin lotus root starch. Gradually, they can eat some porridge, soft thin noodles, and thin noodles. They should continue to drink plenty of water and avoid eating foods rich in protein and fat, as well as those that are easy to cause bloating and those with high fiber content.

　　3. After the condition improves, for example, when the abdominal pain stops, the frequency of defecation decreases, and the body temperature approaches normal, one can start eating egg soup, steamed egg custard, yogurt, congee, soup, toast, steamed fish, minced lean meat, tender green leaves, and so on. The amount of food per meal should be small.

　　4. During the recovery period, it is advisable to eat easily digestible, low in irritation, and light in bloating foods, and try to make them soft and light.

　　1. Treatment Principles
　　It is necessary to understand the type of腐蚀剂 ingested and to supplement sufficient nutrition through early intravenous fluid replacement, correct electrolyte and acid-base imbalances, and keep the respiratory tract unobstructed. Fasting is recommended, and it is generally advised against gastric lavage to prevent perforation. If there are signs of esophageal or gastric perforation, surgery should be performed as early as possible.

　　2. Alleviating Secondary Damage
　　To reduce the absorption of toxins and alleviate the degree of mucosal burns, those who have swallowed strong acid can first drink plenty of water, take 30-100ml of aluminum hydroxide gel orally, or be given 100-200ml of cow's milk, egg white, or vegetable oil as soon as possible. Those who have swallowed strong alkali can be given vinegar mixed with warm water to drink, and it is generally not advisable to take concentrated vinegar, as the heat produced when concentrated vinegar reacts with alkaline compounds can exacerbate the damage, and then a small amount of egg white, cow's milk, or vegetable oil can be taken.

　　3. Symptomatic Treatment
　　Painkillers such as morphine 10mg intramuscular injection should be given to those with severe pain; oxygen inhalation should be given to those with respiratory difficulty; for those with laryngeal edema and severe respiratory obstruction, tracheotomy should be performed as early as possible, and broad-spectrum antibiotics should be used to prevent secondary infection. In the early stage, to avoid the occurrence of laryngeal edema, corticosteroids can be used appropriately within 24 hours of onset to reduce local edema of the throat and can also reduce the formation of collagen and fibrous scar tissue. Hydrocortisone 100-200mg or dexamethasone 5-10mg can be administered intravenously, and after several days, prednisone tablets can be taken orally, but long-term use should be avoided.

　　4. Treatment of Complications
　　For those with concurrent esophageal stenosis or pyloric obstruction, endoscopic balloon dilation treatment can be performed; when there is local stenosis of the esophagus, stent implantation can be performed, and it is not advisable to perform dilation or stent treatment, and surgical treatment should be performed.