Pathology of the Stomach Flashcards
What are the 2 main types of inflammatory disorders of the stomach
Acute Gastritis and Chronic Gastritis
What are the 3 main types of chronic gastritis
Autoimmune (rare)
Bacterial (H pylori)
Chemical
What is autoimmune chronic gastritis caused by
Anti-parietal and anti-intrinsic factor antibodies are present = B12 deficiency
What can happen to the spinal cord in autoimmune chronic gastritis
Demyelination of the spinal cord
What is autoimmune chronic gastritis
A pre-malignant condition
What is the most common type of chronic gastritis and what happens with it?
H. Pylori - pathogenetic
Causes damage to the epithelium and other aspects of the wall
What does H pylori increase the risk for
Duodenal ulcer
Gastric ulcer
Gastric carcinoma
Gastric lymphoma
What is the cause of chemical gastritis
Due to NSAIDs, alcohol, bile reflux
What might chemical gastritis produce
Erosions or ulcers
What is a peptic ulceration
Peptic ulceration is a breach in the GI mucosa as a result of acid and pepsin attack
How can you heal an ulcer
Switch off the acid production in the stomach
Where can chronic peptic ulcers be found?
Duodenum (very common)
Stomach
Oesophago-gastric junction
Stomal ulcers (very rare)
What are important in terms of chronic peptic ulcers
Increased acid production and failure of mucosal defence
Describe the appearance of peptic ulcers
Layered
Floor of necrotic fibinopurulent debris
Base of inflamed Granulation tissue
Deepest layer is fibrotic scar tissue
What are 5 complications of peptic ulcers
Perforation Penetration Haemorrhage Stenosis Intractable pain
What are the 2 types of gastric tumours
Benign (polyps) and malignant (tumours)
What are the 2 branches of malignant gastric tumours
Carcinoma and Lymphoma
Describe the epidemiology of gastric adenocarcinomas
High incidence in Asia (genetic factors?)
Decline in the western world
Diet is thought to have a major effect
What is the difference in prognosis between intestinal and diffuse
Better prognosis for intestinal
Where can gastric adenocarcinoma spread
Local - other organs in the peritoneal cavity and ovaries
Lymph nodes - anywhere in the body
Haematogenous - to the liver through the portal vein