Gastric response to severe head injury

Area of Science:

• Gastroenterology
• Trauma Surgery
• Neurocritical Care

Background:

• Severe head injury and multiple trauma can significantly impact physiological responses.
• Gastric complications are a concern in critically ill patients.
• The specific gastrointestinal effects of severe head injury require further elucidation.

Purpose of the Study:

• To investigate the gastric response to severe head injury.
• To assess gastric acid secretion, serum gastrin, and pancreatic polypeptide levels in patients with severe head injury.
• To explore the relationship between head injury, intracranial pressure, and these gastrointestinal markers.

Main Methods:

• Endoscopic examination of the upper gastrointestinal tract in patients with severe head injury.
• Measurement of gastric acid secretion rates.
• Assay of serum gastrin and pancreatic polypeptide levels.
• Comparison between patients with severe head injury and trauma patients without head injury.

Main Results:

• All patients undergoing endoscopy (22/32) with severe head injury exhibited gastritis or duodenitis.
• Gastric acid secretion was not significantly different between groups.
• Serum gastrin levels were normal and did not correlate with intracranial pressure.
• Pancreatic polypeptide levels were significantly elevated in patients with severe head injury.

Conclusions:

• Erosive gastritis is a common finding in severe head injury.
• Severe head injury is associated with significantly increased pancreatic polypeptide levels.
• Increased pancreatic polypeptide may be linked to elevated intracranial pressure and heightened vagal activity originating from the brainstem.