Pathology GI Tract Flashcards
Sialadenitis
Inflammation/enlargement of the salivary glands
(Salivary Gland: parotid, submandibular, sublingual)
What can cause Sialadenitis
- Mumps
- Sjogren Synd. (autoimmune / all salivary glands + lacrimal gland)
- Bacterial: Secondary to duct obstruction by stone
If an adult male has the mumps what can occur
Orchitis: inflammation of the testes
Salivary Gland Tumors
- 80% in Parotid
- 80% benign
Name a benign salivary gland tumor
Pleomorphic Adenoma
Pleomorphic Adenoma
- More common tumor
- mostly in the PAROTID
- slow growing
- well demarcated
- encapsulated painless swelling at angle of jaw
- recurs after excision in 10%
- multiple projections of the tumor penetrate the capsule
- primary/recurrent benign tumors present for many years (10-20) may lead to malignancy (if malignant it will spread via lymph nodes)
What might you see in the parotid gland of a patient with Pleomorphic Adenoma
Cartilage
What could be confused for mumps
Pleomorphic Adenoma
Esophagus Motor Disorder: ACALASIA
- Failure to relax lower esophageal sphincter
- No peristalsis in esophagus
(Peristalsis: involuntary contraction/relaxation of intestine muscles [or other canals] to push contents out)
Causes of Acalasia
- Loss of ganglion cells in the myenteric plexus
- Trypansoma cruzi infection of Chaga ds. in South America
(Myenteric plexus: major nerve supply to GI tract that controls motility)
(Trypansoma CRUZI - CHAGA - CARDIAC - KISSING BUG ** just a little micro reminder)
Effects of Acalasia
- Retention of food in the esophagus
- Wall will be normal thickness, thicker than normal (hypertrophy of muscle) or thinner (dilation)
- Mucosal inflammation & ulceration —> Squamous cell carcinoma
Manifestations of Acalasia
* Clinically: progressive dysphagia (difficulty swallowing)
* Nocturnal regurgitation & aspiration of food
* Pain
Esophagus Motor Disorder: ESOPHAGITIS
Inflammation/irritation of the esophagus
Causes of Esophagitis
- Reflux of acid pepsin due to hiatal hernia
- Ingestion of irritants
- Infection: Herpes Candida albicans (in immunosupressed)
Manifestations of Esophagitis
- Dysphagia (difficulty swallowing)
- Retrosternal pain (pain behind the breastbone or sternum ** Heartburn)
Esophagus Motor Disorder: HIATAL HERNIA
- Herniation of the stomach through the esophageal hiatus in the diaphragm
- Due to enlargement of the hiatus & laxity of connective tissue (why this part happpens is unknown)
Types of Hiatal Hernias
- Sliding Hernia
- Paraesophageal hernia
Hiatal Hernia: SLIDING HERNIA
cap of gastric cardia moves upward above the diaphragm
Hiatal Hernia: PARAESOPHAGEAL HERNIA
herniation of part of the gastric fundus that is next to the esophagus
Manifestations of Hitatal Hernia
- Regurgiation of food (gastroesophageal reflux ds GERD, which can lead to Barrett’s esophagus
- Retrosternal pain (heartburn)
- Exacerbated in recumebt postion that facilitates reflux (worse when laying down)
Complications of Hiatal Hernia
- Ulceration
- Bleeding
- Barrett Esophagus ***
Barrett Esophagus
- Squamous epithelim is replaced by mucus-secreting columnar epithelium into gastric or intestinal type
- increased risk of malignant transformation in to adenocarcinoma (30-40x)
(metaplasia: one adult cell changes to another type of adult cell)
What type of epithelium is in the esophagus
stratisfied squamous epithelium
In Barrett Esophagus what replaces the squamous epithelium of the esophagus
mucus-secreting columnar epithelium in to gastric or intestinal type
In Barrett Esophagus, if malignant transformation happens, what is the most common location
lower 1/3 of the esophagus
What could develop in Barrett Esophagus
Esophageal Varicies: enlarged veins in the esophagus
if they reuputre it will cause hematemesis (vomitting blood)
If there is malignant transformation in Barrett Esophagus, what would you expect to find
Dysplastic cells
(dysplasia: a cell is unrecongizable)
What protects the stomach from gastric acid
mucus-secreting columnar epithelium
Esophagus Motor Disorders: LACARATION (MARY-WEISS SYND)
Failure of the relaxation part of peristalsis causing the reflux gastric contents to overwhelm constriction at the gastroesophageal junction
This leads to massive dilation and tear of the esophagus
Who would you most likely see an esophageal laceration in
- Alcoholics
- Bulimics
Esophageal Laceration
Longitudinal tear, several cm in length at the gastroesophageal junction
An esophageal laceration can cause
- Hemorrhage
- Infection
If an esophageal laceration causes hemorrhage, where could the bleeding go and what is term for it
It will go in to the peritoneal cavity
HEMOPERITONEUM
If an esophageal laceration causes infection, where could the infection spead and what at the respective terms
It could spread to:
- Peritoneal - PERITONITIS
- Mediastinum - MEDIASTINITIS
- Pleural space (by lungs) - Empyema
