Upper GI tract pathology Flashcards
Name 5 upper GI tract pathologies
Oesophageal reflux/cancer
Gastritis
Peptic ulceration
gastic cancer
What can cause oesophageal reflux
hiatal hernia
What can oesophageal reflux do?
Thickening of squamous epithelim and ulceration of oesophagus if severe
name some complications of oesophageal reflux
Baretts oesophagus
oesophageal obstruction
impaired oesophageal motility
stricture (narrowing) due to fibrosis
what is Barrett’s oesophagus
a pre malignant condition in response to oesophageal reflux . It is a type of metaplasia from squamous epthelium to glandular epithelium
Oesophageal Cancer is how common?
Third commonest cancer of alimentary tract
What are the histological types of oesophageal cancer
squamous cell carcinoma and adenocarcinoma (deveops from barrett’s oesophagus)
Risk factors for squamous carcinoma
smoking,alcohol, dietary carcinogens
Risk factors for adenocarcinoma
Barrett’s metaplasia and obesity
Local effects of oesophageal cancer?
ulceration,perforation, obstruction
blood spread of oesophageal cancer goes to?
Liver
What is the prognosis of oesophageal cancer
very poor.5 year survival rate less than 15%
What is gastritis
inflammation of the stomach
what are the types of gastritis
Autoimmune (Type A) Bacterial (most common type B ) Chemical injury (type C)
Autoantibodies of which cells are involved in autoimmune gastritis
Parietal cells and intrinsic factor
What happens in gastritis
Atrophy of specialized acid secreting cells on gastric epithelium causing loss of specialised epithelial cells
what does Loss of specialised gastric epithelial cells cause
decreased acid secretion and loss of intrinsic factor produced by stomach
What is bacterial gastritis related to
helicobacter pylori
What is H pylori
Gram negative bacteria that is found on the epithelial surface in mucus.
What does H pylori do
Produces acute and chronic inflammatory response and increases acid production
What is chemical gastritis due to
bile reflux
drugs (NSAIDS)
alcohol
Why does peptic ulceration happen
due to an imbalance between acid secretion and mucosal barrier
What does peptic ulceration affect
Oesophagus (lower), stomach (body and antrum) and duodenum (first and second part)
What is peptic ulceration usually associated with
H pylori and increased gastric acid
What are the complications of peptic ulceration and mechanisms
- Healing by fibrosis leading to obstruction
- Perforation leading to peritonitis
- Bleeding (acute = haemorrhage and chronic = Anaemia)
How common is gastric cancer
2nd most common cancer of GI tract
What is gastric cancer associated with
H pylori
What kind of cancer
histology is gastric cancer
adenocarcinoma
What is transcoelomic spread
spread within peritoneal cavity or pelvis via peritoneal spread
Prognosis of stomach cancer?
Very poor as survival rate of 5 years is 20%
