Gastric Diseases

Question 1

Gastric Volvulus

Answer 1

Abnormal rotation of stomach 180 degrees. Treat with surgery.

Question 2

Bezoar

Answer 2

Concretions of material (food or non-food). Remove endoscopically or surgically.

Question 3

Gastric outlet obstruction

Answer 3

Obstruction from narrowing of pylorus or duodenal bulb. Caused by PUD, cancer, polyps, bezoar, etc. Treat with dilation, stent, surgery, or treating underlying condition

Question 4

Pyloric stenosis

Answer 4

Narrowing of pylorus (common in infants due to pyloric hypertrophy). Diagnosed with olive sign or ultrasound. Treat with pyloromyotomy.

Question 5

Gastric varices

Answer 5

Found in cases of cirrhosis and portal HTN. Causes massive UGI.

Question 6

Portal hypertensive gastropathy

Answer 6

Dilated and ectatic mucosal vessels found in cases of cirrhosis and portal hypertension. Causes UGI bleeding and mucosal oozing

Question 7

Gastric Antral Vascular Ectasia

Answer 7

Watermelon stomach found in scleroderma or cirrhosis caused by ectatic mucosal vessels. Causes bleeding and anemia

Question 8

Dieulafoy’s Lesion

Answer 8

Dilated, aberrant submucosal arteriole erodes overlying mucosa without ulceration. Causes UGI bleeding.

Question 9

Menetrier’s Disease

Answer 9

Protein-losing hypertrophic gastropathy. Large gastric folds with protein loss into GI tract -> hypoalbuminemia. Caused by EGFR mutation, CMV or H. Pylori infection

Question 10

Autoimmune Metaplasia Atrophic Gastritis

Answer 10

Inflammation of gastric mucosa. Antibodies to parietal cells cause destruction -> gastric atrophy -> hypochlorhydria. Antibodies to intrinsic factor -> pernicious anemia

Question 11

Peptic ulcer disease

Answer 11

Disruption of normal balance between gastric acid secretion and gastroduodenal mucosal defense causes gastric and duodenal ulcers. Often caused by H. pylori, NSAIDs, cancer. Treat with PPI, antibiotics (for H. Pylori), ablation or surgery for bleeding.