Gastric Erosions & Ulceration

"pathological defects in the epithelial surfaces from acute/chronic mucosal damage"
Most common in stomach and duodenum (though it can occur anywhere in the GIT)


Erosions
Superficial mucosal defects
No breach of the muscularis mucosa
Most associated with acute gastritis

Ix
Macro
Small, flat, hyperaemic patches
Histology
Epithelial disruption
Acute inflammation of the lamina propria

Tx
Healing swift once stimulus removed


Ulcers
Breaches the muscularis mucosa to the submucosa/deeper

Acute Ulceration
Aetiology
NSAIDs
Severe physiological stresses (shock/sepsis/burns (Curling's ulcer))
Chemical poisoning
5-10% ITU admissions = acute ulceration

Ix
Multiple/small (<1cm)
Surrounding mucosa initially normal then inflammatory and haemorrhagic
No scarring
Micro

• Mucosal excavation
• Superficial fibrinoid necrosis
• Acute inflammation within mucosa
• Active granulation tissue

Healing within days to weeks

Chronic Ulceration

On background of sustained mucosal injury

Most commonly peptic (see PUD)