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Pathogenesis, diagnosis, and management of gastric ischemia

Shou-Jiang Tang1, Sumanth R Daram1, Ruonan Wu1

  • 1Division of Digestive Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi.

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
|August 8, 2013
PubMed

Insights

Gastric ischemia, a rare condition, stems from insufficient blood flow to the stomach. Prompt diagnosis and management, including fluid resuscitation and acid reduction, are crucial for improving patient outcomes.

Area of Science:

  • Gastroenterology
  • Vascular Medicine
  • Pathology

Background:

  • Gastric ischemia is under-recognized in clinical practice and medical literature.
  • Multiple terms are used to describe gastric ischemia, necessitating clear definition and review.
  • Understanding gastric ischemia's pathogenesis, diagnosis, and management is critical.

Observation:

  • Six cases of gastric ischemia were reviewed.
  • The study discusses the gastric vascular supply.
  • Literature on gastric ischemia was comprehensively reviewed.

Findings:

  • Gastric ischemia arises from vascular insufficiency due to hypotension, vasculitis, or thromboembolism.
  • Management involves fluid resuscitation, nasogastric tube placement, aggressive acid reduction with proton pump inhibitors, and antibiotics for sepsis or gastric pneumatosis.
  • Gastric ischemia can be diffuse or localized.

Implications:

  • Gastric ischemia carries a poor prognosis.
  • Early diagnosis is essential for effective patient management.
  • Standardized diagnostic criteria and treatment protocols are needed.
Abstract

Keywords:
CTEndoscopyGIGastric IschemiaGastrointestinal BleedingIschemiaNGPPIStomachUlcerationcomputed tomographygastrointestinalnasogastricproton pump inhibitor

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