Pathology Of Upper GI Tract Flashcards
What is meant by the term “oesophageal reflux”
The reflux of gastric acid into the oesophagus
What affects can oesophageal reflux have on the epithelium of the oesophagus?
It will thicken the squamous epithelium and in severe cases cause ulceration of the oesophagus
What are two common complications of oesophageal reflux?
Fibrosis occurring from healing and Barrett’s oesophagus
What problems can arise as a result of fibrosis after oesophageal reflux?
Stricture formation
Impairs oesophageal motility
Oesophageal obstruction
What histological change occurs in Barrett’s oesophagus?
The squamous epithelium of the oesophagus transforms into glandular epithelium
What are the two histological types of oesophageal cancer and which develops from Barrett’s oesophagus?
Squamous carcinoma
Adenocarcinoma (develops from Barrett’s oesophagus)
What are the risk factors for oesophageal squamous carcinoma?
Smoking, alcohol and dietary carcinogens
What are the risk factors for oesophageal adenocarcinoma?
Barrett’s oesophagus and obesity
What are the local effects of oesophageal cancer?
Obstruction
Ulceration
Proliferation
What are the forms of spread of oesophageal cancer and where does each spread to?
Direct spread to surrounding structures
Lymphatic spread to regional lymph nodes
Blood spread to liver
What is the five year survival rate of oesophageal cancer?
Less than 15%
What are the three types of gastritis
Type A- autoimmune
Type B- bacterial
Type C- chemical injury
What do the autoantibodies correspond to in autoimmune gastritis
Parietal cells and intrinsic factor
Describe the pathology of autoimmune gastritis
A trophy of specialised acid secreting gastric epithelium causes loss of specialised gastric epithelial cells, which decreases acid secretion and causes a loss of intrinsic factor. This loss of intrinsic factor causes vitamin B12 deficiency (pernicious anaemia)
What bacteria causes bacterial gastritis?
H. Pylori
What are the common causes of chemical gastritis?
Drugs
Alcohol
Bile reflux
What is the most common cause of peptic ulceration?
Usually H.pylori related, the bacteria causes increased gastric acid resulting in an imbalance between acid secretion and the mucosal barrier
What parts of the GI tract can be affected by peptic ulceration?
The lower oesophagus
The body and the antrum of the stomach
The first and second parts of the duodenum
What are the common complications of peptic ulceration?
Bleeding
Perforation- can cause peritonitis
Healing by fibrosis- can cause obstruction
What histological type of cancer is gastric cancer?
Adenocarcinoma
What are the different routes of spread of stomach cancer- and where does each spread to?
Direct spread to surrounding structures
Lymphatic spread to regional lymph nodes
Blood spread to liver
Transcoelomic spread within peritoneal cavity
What is the five year survival rate of stomach cancer?
Less than 20%
