Pathologic Basis of Gastric Disease Flashcards
Hypertrophic pyloric stenosis
hyperplasia of muscularis propria of pyloris
advantageous facters of H pylori
- flagella to maneuver through gastric mucus
- adhesion molecules bind to gastric foveolar cells
- acid resistance through abundant urease
- elaboration of toxins that cause tissue damage
- minimization and evasion of immune response
What type of bacteria is H pylori
Gram (-) bacillus adapted to gastric environment
route of transmission
oral-oral, fecal-oral, environmental spread
what is H pylori infection associated with
poverty, household crowding, rural areas, certain groups
What condition can H pylori infection cause
chronic gastritis (inflammation + injury)
where is H pylori more prevalent in world
High in S America, Africa, Far East
When are you most likely to develop H pylori infection in developing vs developed countries
US – more likely later in life
Developing – still more later in life but many more infections in younger people
Diseases associated with H pylori
- gastritis
- gastric and duodenal ulcers (15% lifetime risk),
- gastric adenocarcinoma (1% lifetime risk)
- Gastric lymphoma
What populations are have more autoimmune gastritis
Scandanavian and northern European descent
Peptic ulcer disease
acid mediated ulceration of stomach & duodenum
Complications of Peptic Ulcer disease
bleeding (15%), perforation (5%), obstruction (2%)
Hypertrophic gastropathies
Menetrier disease, Zollinger-Ellison syndrome
Benign neoplastic diseases of stomach
Inflammatory/hyperplastic polyp
- Fundic gland polyp
- Adenomatous polyp (adenoma)
Malignant (potentially) types of neoplastic diseases
Adenocarcinoma, lymphoma, carcinoid tumor, bastrointestinal stromal tumor
Benign gastric rate polyps from more to less common
Inflammatory/hyperplastic polyp > fundic gland polyp > Adenoma > juvenile polyp and Peutz-Jeghers polyp
Type of malignant gastric neoplasms
adenocarcinoma, lymphoma, carcinoid tumor, Gastrointestinal stromal tumor
Adenocarcinoma incidence
90% of malignant gastric tumors
2nd most common cause of death worldwide (only 2.5% cancer deaths in US)
Risk factors for adenocarcinoma
environment (Diet) and Helicobacter
symtposm of adenocarcinoma
Early: dyspepsia, dysphagia, nausea
Late: weight loss, anorexia, early satiety, anemia
mortality of adenocarcinoma
HIGH
- 5 year survival 30% (90% for early detection)–not usually detected early
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