Acute gastroenteritis is characterized by increased stool frequency and loose consistency, with or without vomiting and abdominal pain. It is the leading cause of morbidity and mortality in childhood. Dehydration and electrolyte loss due to diarrhea and vomiting are the main causes of death. Patients may present with diarrhea, vomiting, fever, and abdominal cramping. Diagnosis is usually clinical but workup including blood tests and stool culture may be needed if systemic infection is suspected. Management involves fluid resuscitation and oral rehydration therapy. Severe dehydration requires intravenous fluids while complications include dehydration, electrolyte abnormalities, and carbohydrate intolerance.

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