Acute corrosive gastritis

　　This disease is caused by acute injury to the gastric wall due to accidental or intentional ingestion of corrosive agents (strong alkalis such as caustic alkali, strong acids such as hydrochloric acid, sulfuric acid, nitric acid, phenol) and is related to the nature, concentration, and amount of the corrosive agent, the time of contact between the corrosive agent and the gastrointestinal tract, and the amount of food in the stomach.

　　1, severe cases may have 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 abdomen. It is often accompanied by pain in swallowing, difficulty in swallowing, frequent nausea and vomiting. The mild gastric lesion may only have congestion, edema, and erosion, and there is often mucosal bleeding; severe cases may have acute ulcers, necrosis of the gastric wall, or even perforation causing peritonitis; severe cases may vomit blood, vomit blood-like mucosal pieces, and the patient may experience fainting or shock.
　　After contact between the mucosa of the lips, mouth, and throat with corrosive agents, different-colored scabs can be produced. Therefore, it is necessary to pay special attention to the color changes of the oral mucosa to help differentiate various corrosive agent poisoning. 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, do not overeat or eat unclean food, or drink alcohol and take irritating drugs. In addition, enough attention should be paid to the primary diseases that can produce endogenous stimulating factors, and they should be treated and removed 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 as much as possible in daily life, pay attention to dietary hygiene, do not overeat or eat unclean food, or drink alcohol and take irritating drugs. In addition, enough attention should be paid to the primary diseases that can produce endogenous stimulating factors, and they should be treated and removed 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 there is roughness of the gastric antrum mucosa, whether the gastric cavity is deformed, whether the esophagus is stenosed, and can also understand the degree of stenosis of the gastric antrum or pyloric obstruction; in the late stage, if the patient can only swallow liquid, he can swallow iodine water contrast examination.

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

　　1, drink plenty of water to replenish the water and salt lost due to vomiting and diarrhea. Generally, every hour1times, drink150-200 milliliters. Adequate water intake is also beneficial for excreting toxins.

　　2、患者呕吐停止、腹泻次数减少后，选喝少量小米米汤或稀藕粉。以后逐渐吃些粥、煮软的细面条、薄面片等。还要继续多饮水，不要急于吃肉、蛋等含蛋白质与脂肪多的食物和易引起胀气的和食物纤维多的食物。

　　3、病情缓解后，例如腹痛止、便次少、体温接近正常后，可开始吃鸡蛋汤、蒸鸡蛋羹、酸奶、粥、面汤、烤面包、清蒸鱼、瘦肉泥、嫩菜叶等。每餐食量宜少。

　　4、恢复期宜吃易消化、刺激性小和胀气性轻的食物，尽量做得软烂、清淡一些。

　　1.治疗原则
　　应了解口服的腐蚀剂种类，并及早静脉输液补充足够的营养，纠正电解质和酸碱失衡，保持呼吸道畅通。禁食，一般忌洗胃，以免发生穿孔。如有食管或胃穿孔的征象，应及早手术。

　　2.减轻继发的损害
　　为了减少毒物的吸收，减轻黏膜灼伤的程度，吞服强酸者可先饮清水，口服氢氧化铝凝胶30～100ml，或尽快给予牛乳、鸡蛋清、植物油100～200ml口服。吞服强碱者可给予食醋加温水口服，一般不宜服浓食醋，因浓食醋与碱性化合物作用时，产生的热量可加重损害，然后再服少量蛋清、牛乳或植物油。

　　3.Αντιμετώπιση των συμπτωμάτων
　　Ασθενείς με έντονο πόνο δώστε αναλγητικά, όπως η μορφίνη10mg ενδομυϊκή ένεση; Για τους ασθενείς με αναπνευστική δυσκολία, δώστε αναπνοή οξυγόνου; Για τους ασθενείς με οίδημα του λάρυγγα και σοβαρή αναπνευστική μπλοκαρισμό, πρέπει να γίνει χειρουργική επέμβαση για τομή του气管, και να χρησιμοποιηθούν ευρύ φάσματος αντιβιοτικά για την πρόληψη της λοιμώδους ασθένειας. Στο αρχικό στάδιο, για να αποφύγουμε την ανάπτυξη οίδηματος του λάρυγγα, μπορεί να δοθεί κατάλληλα κατά την εμφάνιση της ασθένειας24h μέσα, χρησιμοποιώντας ορμόνες της επιδερμίδας της επινεφρίδας, για να μειώσει το τοπικό οίδημα του λάρυγγα, και μπορεί να μειώσει τη δημιουργία κολλαγόνου και ινώδους ουλής. Μπορεί να χρησιμοποιηθεί υδροκορτιζόνη.100～200mg ή dexamethasone5～10mg ενδοφλέβια ένεση, μετά από αρκετές ημέρες μπορεί να αλλάξει σε δισκίο prednisone κατά προτίμηση, αλλά δεν πρέπει να λαμβάνεται μακροπρόθεσμα.

　　4.Θεραπεία των επιπλοκών
　　Για τους ασθενείς με συνδυαστική στένωση της οισοφαγής και οπίσθιον μανίκιο, μπορεί να γίνει ενδοσκοπική επέμβαση με ballon dilatation; Στην τοπική στένωση του οισοφάγου, μπορεί να τοποθετηθεί支架 για τη θεραπεία, οι ασθενείς που δεν είναι κατάλληλοι για επέμβαση με ballon dilatation ή支架 πρέπει να υποβληθούν σε χειρουργική επέμβαση.