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.
Czaja AJ, McAlhany JC, Andes WA, Pruitt BA. Acute Gastric Disease After Cutaneous Thermal Injury. Arch Surg. 1975;110(5):600–605. doi:10.1001/archsurg.1975.01360110146024
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