Pathology of the Upper-GI Tract Flashcards
What is at the GOJ (gastro-oesophageal junction)?
The lower oesophageal sphincter
Pyloric sphincter where?
End of stomach (end of pylorus)
Oesophagus epithelium?
Stratified squamous
PAthology of oesophageal reflux?
reflux of acid into oesophagus
thickening of squamous epithelium
Ulceration (stripping) of oesophageal epithelium in severe reflux cases
Hyperplasia vs hypertrophy?
hyperplasia = increase in no.
hypertrophy = increase in size
What is ulceration?
stripping of the epithelium which then exposes blood vessles, cells etc
Complications if oesophageal reflux
ulceration and healing by fibrosis (forms stricturs, imparining motility and potential obstruction
Barretts oesophasgus,
WHa is Barrett’s oesophagus?
metaplasia of the lower oesophagus (Stratified squamous to mucosal like the stomach)
meatplasia - cancer journey
Normal healthy cells, metaplasia, dysplasia, neoplasia (cancerous)
hat are planeth cells?
the regenarative cells of the (GI?) oesophagus
Top 3 cancers in gi tract
- Adenocarcinoma of the colon
- Gastric cancer
- Oesophageal cancer
What cancer type develops from barrets oesophagus?
adenocarcinoma (the glandular one because the squamous epithelium that was there is now mucosal glandular epithelium)
Risk factors for oesophageal cancer : quamoos/adenocarcinoma
Squamous: Heavy drinker, smoker, carciogenic foods eg smoked things
Adenocarcinoma: Barretts Oesophagus, obesity (pulls on LOS and makes reflux more likely). Also foods high in vitamin K eg banana (causes more acid)
What tyoe of food in your diet puis more likely to cause oesophagela refulx?
high in vit K (potassium)
How can oesophageal cancer spread?
Through blood, lymph and adjacent tissues
What are the 3 pathologies of gastritis?
A = Autoimmune/atrophic
B = Bacterial (H.Pylori)
C = Chemical injury
What to look for to decide what type of gastritis?
History (atopic conditons),
B12 deficincy means which gastritis?
Autoimmune, because causes atrophy and loss on intrinsic factor, and therefore vitamin B12 (pernicious anaemia)
Histological findings A gastritis
Atrophy of the gastric epithelium. So loss of specialised gastric epithelial cells, reduction in gastric acid secretion and loss of intrinsic factor production.
How does H. Pylkori cause disease in the stomach?
Produces K, effect on epithelium, able to get closer to epithelium ()less acidic)
Most common ype of gastritis?
Bacterial
Treatment of bacterial gastritis
Omeprazole and antibiotics
What is chemical gastritis usually casused by?
Drugs, inc. NSAIDs, alcohol
What else can cause chemical gastriis
Bile reflux
Chemical gastritis histology
“corckscrewing” of gastric epithelium. No inflammation or microorganisms.
Peptic ulceratoin complications
Bleeding
Acute = haemorrhage
Chronic = anaemia
Perforation - Peritonitis
Healing by fibrosis - Obstruction
What is melena?
Black stools due to old blood in the poo (from a gastric bleed lower down in the GI tract usually)
Metaplastic change of gastric cancer
adenocarcinoma
Where does stomach cancer spread to?
Direct: to surrounding tissues eg. pancreas
Lymphatic spread (regional lymph nodes)
Blood spread (to liver)
Transcoelemic spread
Prognosis oesophpgeal vs stomach cancers
Both very poor.
Oesophageal 5 year = less than 15%
Gastric 5 year = less than 20%
