Pathology of the stomach Flashcards
What are the types of Gastritis?
- Acute- Irritant chemical injury
- Chronic- Autoimmmune, bacterial & chemical (ABC)
- Rare- Lymphocytic, eosinophilic, granulomatous
What are the types of Chronic Gastritis?
- Autoimmune
- Bacterial- H. Pylori
- Chemical
What happens in autoimmune chronic gastritis?
Anti- parietal and anti-intrinsic factor antibodies produced
Causes atrophy & intestinal metaplasia
Pernicious anaemia.
What happens in H.pylori gastritis?
H. Pylori inhibits a niche between epithelial surface and mucous barrier.
Initiates early acute inflammatory response
If not clear leads to a chronic active inflammation- IL-8 a key player.
H. Pylori can incerase risks of what? (4)
- Duodenal ulcer
- Gastric ulcer
- Gastric carcinoma
- Gastric lymphoma
Chemical gastritis is caused by what? (4)
- NSAIDs
- Bile reflux
- Alcohol
What is the pathology of chemical gastritis?
Direct injury to mucus layer by fat solvents
Marked epithelial regeneration, hyperplasia and congestion. Lil inflammation.
Chemical gastritis can lead to _ and _
Erosions & ulcers
What is a peptic ulcer?
Breach of GI mucosa due to acid/pepsin attack
Common sites of chronic ulcers?
- Duodenum
- Stomach
- Oesophago-gastric junction
- Stomal ulcers
What happens to acid secretion in duodenal ulcers?
Increased
Excess acid- gastric metaplasia, H.pylori infection, inflammation, epithelial damage & ulceration
In chronic peptic ulcers, failure of mucosal _ as well as increased acid secretion is important
Defence
What are the important complications of peptic ulcers?
- Perforation
- Penetration
- Haemorrhage
- Stenosis
- Intractable pain
What are the benign gastric tumours? (hint-polyps)
- Hyperplastic polyps
- Cystic fundus gland polyps
What are the malignant tumours of the stomach?
- Carcinoma
- Lymphoma
- GI stromal tumours (GIST’s)
