Upper GI Flashcards
What are the 3 components of the anatomy of the upper GI tract?
Esophagus
Stomach
Intestines
What is chronic gastritis?
Ongoing inflammation of stomach mucosa
What can chronic gastritis be a possible environment for?
Dysplasia and carcinoma
What are the symptoms of chronic gastritis?
Upper abdominal pain Indigestion/bloating Nausea/vomiting Belching Loss of appetite/weight loss
What are the ‘ABC’ causes of chronic gastritis?
Autoimmune
Bacterial (helicobacter pylori)
Chemical (alcohol, tobacco, caffeine)
What is helicobacter pylori?
Gram negative bacterium found in stomach (antrum)
How is helicobacter pylori acquired?
Faecal-oral
What is helicobacter pylori associated with?
Chronic gastritis Duodenal ulcer Gastric ulcer Gastric carcinoma Gastric MALT lymphoma
Where do peptic ulcers occur?
D1 or antrum
What are the causes of peptic ulcer?
Helicobacter pylori and NSAIDS
What are the symptoms of peptic ulcers?
Pain (gnawing, burning, aching (worse at night & after meals))
What are the complications of peptic ulcers?
Bleeding leading to anaemia
Haematemesis (vomiting blood)
Perforation leading to peritonitis
Long term cancer
What is barrett’s oesophagus?
Oesophagus lined with columnar epithelium with goblet cells instal of stratified squamous epithelium
What is the cause of barrettes oesophagus?
Adaptation to chronic acid exposure from reflux
What are the 2 types of oesophageal cancer?
Squamous carcinoma
Adenocarcinoma
What are the 2 types of stomach cancer?
Adenocarcinoma
GI stromal tumours
What are the 3 types of small bowel cancer?
Lymphoma
GI stromal tumours
Neuroendocrine tumours
What are the risk factors of oesophageal squamous cell carcinoma?
Alcohol, tobacco, caustic injury, achalasia
What are the symptoms of oesophageal squamous cell carcinoma?
Dysphagia, weight loss, haemorrhage, sepsis, respiratory fistula with aspiration
What does barrett’s oesophagus lead to?
Oesophageal carcinoma
What are the symptoms of oesophageal adenocarcinoma?
Dysphagia, weight loss, haematemesis, chest pain, vomiting
Where does oesophageal carcinoma spread directly?
Surrounding tissues
Where does oesophageal carcinoma spread via the lymphatics?
Paraoesophageal, paratracheal, cervical node groups
Where does oesophageal carcinoma spread haematogenously?
Liver and lung
What are the precursor lesions of adenocarcinoma of the stomach?
Pernicious anaemia (atrophic gastritis)
Intestinal metaplasia
Neoplastic polyps
Helicobacter associated gastritis
What are the advanced symptoms of adenocarcinoma of the stomach?
Weight loss, anorexia, anaemia, haemorrhage
Where does adenocarcinoma of the stomach spread via direct infiltration?
Duodenum, pancrea, colon, liver, spleen
Where does adenocarcinoma of the stomach spread via the lymphatics?
Local and regional nodes
Virchow’s node
Where does adenocarcinoma of the stomach spread haematogenously?
Liver and lungs
What other ways can adenocarcinoma of the stomach spread?
Transcoelomic
Omentum
Mesentery
Ovary
What are the 4 subtypes of small bowel neoplasia?
Adenocarcinoma
GI stromal tumour
Lymphoma
Carcinoid (neruoendocrine) tumour
What are the risk factors of small bowel neoplasia?
Crohn’s
Coeliac
Radiation
Genetic e.g. familial adenomatous polyposis
What is coeliac disease?
Extensive mucosal disease related to sensitivity to gluten
How is coeliac diagnosed?
Serological blood test (TTG) and biopsy
What are the symptoms of coeliac disease?
Pain in digestive tract Chronic constipation and diarrhoea Failure to thrive (children) Anaemia Fatigue
What 2 cancers does coeliac lead to an increased risk of?
Adenocarinoma and lymphoma of the small bowel
