Upper GI Tract - Pathology Flashcards
What is oesophageal reflux?
Reflux of gastric acid into oesophagus
What is a hiatus hernia?
Part of the stomach going through the diaphragm into the chest
What is the result of oesophageal reflux?
Acid causes damages to the epithelium of the oesophagus causing inflammation of the squamous epithelium
May also cause ulcers (severe)
What are the complications of oesophageal reflux?
Healing by fibrosis - reduces motility, stricture formation and may cause obstruction
Barretts oesophagus
What is Barrett’s oesophagus?
Transformation from squamous epithelium to glandular epithelium
Pre-malignant condition
What are the 2 histological types of oesophageal cancer?
Squamous carcinoma
Adenocarcinoma
What are the risk factors of squamous carcinoma?
Smoking
Alcohol
Dietary carcinogens
What are the risk factors of adenocarcinoma?
Barrett’s metaplasia
Obesity
What are the 3 local effects of oesophageal cancer?
Obstruction
Ulceration
Perforation
What are different ways of oesophageal cancer spread?
Direct -> surrounding tissues
Lymphatic -> regional lymph nodes
Blood -> liver
What is the prognosis of oesophageal cancer?
Very poor (5 year survival rate less than 15%) Mostly diagnosed after metastases
What are the 3 types of gastritis?
Autoimmune (type A) Bacterial (type B) Chemical injury (type C)
What is autoimmune gastritis?
Autoantibodies to parietal cells and intrinsic factor (organ-specific)
Associated with other autoimmune diseases
What happens in autoimmune gastritis?
Atrophy of specialised acid secreting gastric epithelium
Loss of specialised gastric epithelial cells causes decreased acid secretion and loss of intrinsic factor (B12 deficiency)
What is bacterial gastritis?
Helicobacter pylori related
Gram negative bacterium found in gastric mucus on surface of gastric epithelium that produces acute/chronic inflammatory response
Results in increased acid production
What is chemical gastritis?
Result of drugs (NSAIDS), alcohol or bile reflux from duodenum
What is peptic ulceration?
Imbalance between acid secretion and mucosal barrier
Usually H. pyloric associated (increased gastric acid)
What structures are affected by peptic ulceration?
Lower oesophagus
Body and antrum of stomach
1st and 2nd parts of duodenum
What are the 3 main complications of peptic ulceration?
BLEEDING: acute (haemorrhage), chronic (slow blood loss = anaemia)
PERFORATION: hole in stomach = release of stomach contents into abdominal cavity
FIBROSIS: reduces motility = narrows tube = obstruction = build up of food contents in stomach
How does gastric cancer develop?
Through phases of intestinal metaplasia and dysplasia
Associated with previous H.pylori infection
Adenocarcinoma
What are the 4 types of spread in stomach cancer?
DIRECT: surrounding tissues
LYMPHATIC: regional lymph nodes
BLOOD: liver
TRANSCOELOMIC: within peritoneal cavity
What is the prognosis of stomach cancer?
Very poor: 5 year survival rate less than 20%
