Diseases of Stomach & Duodenum Flashcards
what is gastritis?
inflammation causing mucosal injury of the stomach
types of gastritis
acute or chronic
aetiology of acute gastritis?
chemical injury, trauma, infection
aetiology of chronic gastritis?
CHA CHA
chemical: NSAIDs, alcohol
H.Pylori
Autoimmune
anaemic complications of gastritis
can lead to pernicious anaemia due to B12 def
what are common complications of gastritis?
ulcers & cancer
what is peptic ulceration?
breach in GI mucosa as a result of acid and pepsin attack
what sites are peptic ulcers most common in?
duodenum, stomach, oesophogastric region
aetiology of peptic ulcers?
excess acid production, H.pylori, NSAIDs, smoking
symptoms of peptic ulcer?
burning epigastric pain, loss of appetite, feeling of fullness/nausea, dyspepsia (reflux)
ix for peptic ulcer?
exclude H.Pylori- C13 urease breath test, stool antigen, serology of IgG
exclude cancer with endoscopy
tx for peptic ulcer?
antacids, H2 antagonists, PPI or H.pylori eradication
- omeprazole & amoxicillin & clarithromycin or
- omeprazole & metronidazole & clarithromycin
what are extreme Rx for H.pylori?
metoclopramide or bismuth chelate
complications of peptic ulcer?
perforation, penetration, haemorrhage, stenosis
what are 2 types of benign gastric tumours?
hyperplastic polyps, cystic fundic gland polyps
3 types of malignant Gastric tumours?
carcinomas, lymphomas, GI stromal tumours (GISTs)
what are GISTs linked to and typical pt?
55-60yo, linked to defective pacemaker cells (ICC)
epidemiology of gastric adenocarcinoma?
high incidence in some countries (Japan, china, Colombia, Finland), males, 4th commonest cancer in the world
aetiology of gastric adenocarcinoma?
H.pylori, pernicious anaemia, partial gastrectomy, menetrier’s disease
pathogenesis of gastric adenocarcinoma
h.pylori > chronic gastritis > intestinal metaplasia> dysplasia > carcinoma
where is adenocarcinoma most commonly found?
cardia/ GO junction
what are the 2 classes of gastric adenocarcinoma?
T1: exophytic/ polypoid mass (intestinal)
T2: expands/ infiltrates stomach wall (diffuse)
which of the 2 types of gastric adenocarcinoma is better?
T1- less diffused
where is a common site for metastases of Adeno carcinoma?
liver
symptoms of gastric adenocarcinoma?
epigastric pain, vomiting/ haematemesis, loss of appetite, dysphagia
ix fo gastric Adenocarcinoma?
upper GI endoscopy & biopsy, CXR, CT
tx for gastric adenocarcinoma?
resection, palliative care
true/false…
if cancer is proximal then a surgeon should carry out a partial resection
false…
if proximal= total resection, if distal= partial resection
what is the second type of malignant gastric cancer?
Gastric Lymphoma
what is gastric lymphoma also known as…?
MALToma
what is the aetiology for gastric lymphoma?
caused by H.pylori and derived from Mucosa Associated Lymphoid Tissue (MALT)
what type of lymphoma is gastric lymphoma?
a b-cell lymphoma
what part of the stomach is termed proximal?
the upper part ie. cardia, fundus and body
what 2 structures are termed as the distal stomach?
Antrum & pylorus
