Pathology of upper GI tract Flashcards
What does oesophageal reflux cause?
Thickening of squamous epithelium
In severe cases, ulceration of oesophagus
What are the complications of oesophageal reflux?
Healing by fibrosis- impaired oesophageal motility and oesophageal obstruction
Barrett’s oesophagus- type of metaplasia, transformation of squamous to glandular epithelium
What can Barnet’s oesophagus develop into?
Oesophageal adenocarcinoma
What are the types of oesophageal cancer?
Squamous carcinoma
Adenocarcinoma
What are the risk factors for oesophageal squamous carcinoma?
Smoking
Alcoho
Dietary carcinogens
What are the risk factors for oesophageal adenocarcinoma?
Barrett’s metaplasia
Obesity
What are the local effects of oesophageal cancer?
Obstruction
Ulceration
Perforation
Where does oesophageal cancer commonly spread to and how?
Direct to surrounding structures
Lymphatic to regional lymph nodes
In the blood to the lover
What is the prognosis for oesophageal cancer?
5 year survival <15%
What is gastritis?
Inflammation of the stomach
What are the 3 types of gastritis?
Autoimmune
Bacterial
Chemical
What causes autoimmune gastritis?
Autoantibodies to parietal cells and intrinsic factor
What is the pathology of autoimmune gastritis?
Atrophy and loss of acid secreting gastric epithelium
What is the most common organism associated with bacterial gastritis?
H. pylori
What is the mechanism of bacterial gastritis?
Bacteria causes an acute and chronic inflammatory response, increasing acid production
What chemicals are associated with chemical gastritis?
Drugs, esp NSAIDs
Alcohol
Bile reflux
What is peptic ulceration?
Imbalance between acid secretion and mucosal barrier
Where do peptic ulcers affect?
Lower oesophagus
Body and antrum of stomach
First and second parts of duodenum
What is peptic ulceration associated with?
H. pylori
What are the complications of peptic ulceration?
Bleeding acute or chronic
Perforation causing peritonitis
Healing by fibrosis causing obstruction
What do acute and chronic bleeding in peptic ulceration cause?
Acute= haemorrhage Chronic= anaemia
What is the histology of stomach cancer?
Adenocarcinoma
What is stomach cancer associated with?
Previous H. pylori infection
How does stomach cancer develop?
Through phases of intestinal metaplasia and dysplasia
