Acute Gastroenteritis Seminar

1. ACUTE GASTROENTERITIS
Muhd Adam Haikal bin Anuar
1129200919457

2. INTRODUCTION
• It is a clinical syndrome often characterized by
1. Increased stool frequency, with loose consistency
>3 loose or watery stools in 24 hours
2. With or without vomiting, fever and abdominal pain.
• It is the leading cause of morbidity and mortality in childhood phase.
• Dehydration and electrolyte loss are the main cause of death in acute
gastroenteritis patients

3. PATHOPHYSIOLOGY

5. CLINICAL PRESENTATION
• Although viral enteric infections are asymptomatic at first, but the clinical
presentation varies.
• Patient may be presented with
1. Diarrhea
2. Vomitting
3. Fever
4. Abdominal cramping

6. HISTORY TAKING
 Duration of illness
 Frequency, volume and character of stools
 Frequency, volume and character of vomiting
 Urine output
 Weight loss association
 Recent intake of foods and fluids
 Immunization history
 Exposue of infections

7. PHYSICAL FINDINGS
• Growth parameters - body weight
• Vital signs
 Temperature > 38’C or > 40’C in bacterial gastroenteritis
 Weak, rapid or absent pulse
 Decrease blood pressure
• Sunken anterior fontanelle, sunken eyes
• Tacky, dry, or parched mucous membranes
• Deep respirations
• Severe, localized pain, rebound tenderness, marked abdominal distension

8. DIAGNOSIS
• The diagnosis of acute viral gastroenteritis is made clinically.
• Any child with evidence of systemic infection should have complete workup,
including
Full blood count
Blood culture
 Stool culture

9. MANAGEMENT
• Assess the state of perfusion

10. SEVERE DEHYDRATION
1. Asses Airway, Breathing and Circulation
2. Start Intravenous or intraosseous fluid immediately
3. Initial fluids are 20ml/kg of 0.9% normal saline or Hartmann’s solution as rapid IV
bolus (repeat if necessary)
4. Rehydation by isotonic solution of 0.9% NS or Hartmann’s solution
5. Start maintenance - ORS, 5ml/kg/hour
6. If the child starts to feed without vomitting, rehydrate according to
plan A and B

11. INDICATIONS FOR HOSPITAL ADMISSION
 Severe dehydation or patient is in shock
 Failure of ORS treatment and needed for intravenous therapy
 Other possible illnesses or uncertainty of diagnosis
 Inadequate care if treated at home
 Social and logistical concerns

12. COMPLICATIONS
• Hypovolemia/dehydration
• Electrolyte abnormalities
• Carbohydrate intolerance