Pathology of Upper GI Tract Flashcards
what are symptoms commonly associated with diseases of the upper GI tract
Diseases of upper GI tract which cause upper abdominal or retrosternal discomfort or pain or “indigestion”
what are five pathologies of the upper GI tract
Oesophageal reflux
Oesophageal cancer
Gastritis
Peptic ulceration
Gastric cancer
what pathologies are associated with oesophageal reflux
Reflux of gastric acid into oesophagus
Hiatus hernia
Thickening of squamous epithelium
Ulceration of oesophageal epithelium when severe reflux
are the squamous cells of the oesophagous keratinised or non keratinised
non keratinised
what are complications of oesophageal reflux
Healing by fibrosis
Barrett’s oesophagus
what are the issues of healing by fibrosis in the oesophagous
Stricture formation
Impaired oesophageal motility
Oesophageal obstruction
Barrets oesophagus
the cells of the lining can become abnormal [squamous epithelium turns to glandular epithelium] and there’s a small risk of cancer developing.
is barrets oesophagus a pre malignent condition
yes
is osophageal cancer a common type of cancer
third most common
what are the two histological types of osophageal cancer
squamous carcinoma
adenocarcinoma [develops from barretts oesophagous]
what are ridk factors for squamous carcinoma osophageal cancer
Smoking
Alcohol
Dietary carcinogens
what are ridk factors for adenocarcinoma osophageal cancer
Barrett’s metaplasia
Obesity
what are the local effects of oesophageal cancer
Obstruction
Ulceration
Perforation
how can osophageal cancer spread
directly
lymphatically
blood spread
what is the prognosis of osophageal cancer
Very poor
5 year survival rate less than 15%
what are the pathologies of gastritis
Autoimmune (type A)
Bacterial (type B)
Chemical injury (type C)
autoimmune gastritis
Organ-specific autoimmune disease
Autoantibodies to parietal cells and intrinsic factor
Associated with other autoimmune diseases
what pathologies are associated with autimmune gastritis
Atrophy of specialised acid secreting gastric epithelium
Loss of specialised gastric epithelial cells
what effect does Loss of specialised gastric epithelial cells
Decreased acid secretion
Loss of intrinsic factor
Vitamin B12 deficiency (pernicious anaemia)
bacterial gastritis
Commonest type of gastritis
Helicobacter pylori related
Helicobacter pylori
Gram negative bacterium
Found in gastric mucus on surface of gastric epithelium
Produces acute and chronic inflammatory response
Increased acid production
chemical gastritis cause
Drugs
Non-steroidal anti-inflammatory drugs (NSAIDs) cause
Alcohol
Bile reflux
peptic ulceration
Imbalance between acid secretion and mucosal barrier
what does peptic ulceration efect
Lower oesophagus
Body and antrum of stomach
First and second parts of duodenum
what is peptic ulceration most commonly associated with
H. pylori associated
Increased gastric acid
what are complications of peptic ulceration
Bleeding
Acute = haemorrhage
Chronic = anaemia
Perforation
Peritonitis
Healing by fibrosis
Obstruction
is gastric cancer common
Second commonest cancer of alimentary tract
how does gastric cancer develop
through phases of intestinal metaplasia and dysplasia
what is gastric cancer associated with
previous H.pylori infection
histologicallt what would you find with gastric cancer
adenocarcinoma
prognosis of stomach cancer
Very poor
5 year survival rate less than 20%
how can stomach cancer spread
Direct
Spread to surrounding tissues
Lymphatic
Spread to regional lymph nodes
Blood spread
Liver
Transcoelomic spread
Spread within peritoneal cavity
