The commonly used term STRESS INDUCED GASTRITIS is actually misnomer because Histologically, stress injury does not contain inflammation or H. pylori; thus, "gastritis" is a misnomer.
Although elevated gastric acid secretion may be noted in patients with stress ulceration after head trauma (Cushing's ulcer) and severe burns (Curling's ulcer), mucosal ischemia and breakdown of the normal protective barriers of the stomach also play an important role in the pathogenesis.
Patients suffering from shock, sepsis, massive burns, severe trauma, or head injury can develop acute erosive gastric mucosal changes or frank ulceration with bleeding. Classified as stress-induced gastritis or ulcers, injury is most commonly observed in the acid-producing (fundus and body) portions of the stomach. The most common presentation is gastrointestinal bleeding, which is usually minimal but can occasionally be life-threatening. Respiratory failure requiring mechanical ventilation and underlying coagulopathy are risk factors for bleeding, which tends to occur 48–72 h after the acute injury or insult.
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