Upper GI Tract Pathology Flashcards
Hiatus hernia
Causes a reflux of gastric acid into the oesophagus
Result of oesophageal reflux on squamous epithelium
Epithelium thickens
Severe oesophageal reflux
Ulceration
Complications of oesophageal reflux
Healing by fibrosis
Barrett’s oesophagus
Oesophageal reflux healing by fibrosis
Stricture formation
Impaired oesophageal motility
Oesophageal obstruction
Oesophageal stricture
A narrowing or tightening of the oesophagus that causes swallowing difficulties
Barrett’s oesophagus
Type of metaplasia - from squamous to glandular epithelium
Pre malignant condition
Histological types of oesophageal cancer
Squamous carcinoma
Adenocarcinoma (develops from Barrett’s oesophagus)
Risk factors for oesophageal cancer (squamous carcinoma)
Smoking
Alcohol
Dietary carcinogens
Risk factors for oesophageal cancer (adenocarcinoma)
Barrett’s metaplasia
Obesity
Local effects of oesophageal cancer
Obstruction
Ulceration
Perforation
Presentation of oesophageal cancer
Dysphagia - first food, then liquids
Ulceration
Exposes blood vessels to lumenal contents
Spread of ooesophageal cancer
Direct
Lymphatic
Blood
Direct spread of oesophageal cancer
To surrounding structures
Lymphatic spread of oesophageal cancer
To regional lymph nodes
Blood spread of oesophageal cancer
To liver
Metastases from oesophageal cancer
High proportion of presentations
Type A gastritis
Autoimmune
Type B gastritis
Bacterial
Type C gastritis
Chemical injury
Autoimmune gastritis
Organ-specific autoimmune disease
Autoantibodies to parietal cells and intrinsic factor
Associated with other autoimmune diseases
Pathology of autoimmune gastritis
Atrophy of specialised acid secreting gastric epithelium
Loss of specialised gastric epithelial cells
Loss of specialised acid secreting gastric epithelium
Decreased acid secretion
Loss of intrinsic factor leading to vitamin B12 deficiency (pernicious anaemia)
Bacterial gastritis
Most common form
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
Drugs (NSAIDs)
Alcohol
Bile reflux
Peptic ulceration
Imbalance between acid secretion and mucosal barrier
Affects oesophagus, stomach, duodenum
Usually H. pylori associated
Complications of peptic ulceration
Bleeding
Perforation
Healing by fibrosis
Acute bleeding
Haemorrhage
Chronic bleeding
Anaemia
Perforation
Peritonitis
Pathology of gastric cancer
Develops through phases of intestinal metaplasia and dysplasia
Associated with previous H.pylori infection
Adenocarcinoma
Adenocarcinoma
Glandular cancer
Spread of gastric cancer
Direct
Lymphatic
Blood spread
Transcoelomic spread
Transcoelomic spread
Spread within peritoneal cavity
