Upper GIT Pathology Flashcards
What can diseases of the upper GIT cause?
- Upper abdominal/retrosternal discomfort
- Pain
- Indigestion
What is the pathology of oesophageal reflux?
- Reflux of gastric acid into oesophagus
- Thickening of squamous epithelium
- Ulceration of oesophagus when severe reflux
What are complications of oesophageal reflux?
- Healing by fibrosis
- Barrett’s oesophagus
What can healing of the oesophagus by fibrosis lead to?
- Stricture formation
- Impaired oesophageal motility
- Oesophageal obstruction
What is Barrett’s oesophagus?
- Type of metaplasia
- Pre-malignant condition
- Response in some patients to oesophageal reflux
What metaplasia takes place with Barrett’s oesophagus?
Transformation from squamous epithelium to glandular epithelium
How common is oesophageal cancer?
Third most common cancer of the alimentary tract
What are the 2 histological types of oesophageal cancer?
- Squamous carcinoma
- Adenocarcinoma
Which histological type of oesophageal cancer develops from Barrett’s oesophagus?
Adenocarcinoma
What oesophageal cancer linked to?
- Geographic variation
- Environmental factors
What are the risk factors for squamous carcinoma oesophageal cancer?
- Smoking
- Alcohol
- Dietary carcinogens
What are the risk factors for adenocarcinoma oesophageal cancer?
- Barrett’s metaplasia
- Obesity
What are the local effects of oesophageal cancer?
- Obstruction
- Ulceration
- Perforation
How can oesophageal cancer spread?
- Direct
- Lymphatic spread
- Blood spread
Where can oesophageal cancer spread directly?
To surrounding areas
Where can oesophageal cancer spread through lymphatic spread?
To regional lymph nodes
Where can oesophageal cancer spread through the blood?
Liver
What is the prognosis for oesophageal cancer?
- Very poor
- 5 year survival rate less than 15%
What are the 3 types of pathologies of gastritis?
- Type A: autoimmune
- Type B: bacterial
- Type C: chemical injury
What is autoimmune gastritis?
Organ-specific autoimmune disease
What is autoimmune gastritis associated with?
Other autoimmune diseases
What happens in autoimmune gastritis?
Autoantibodies to parietal cells and intrinsic factor
What is the pathology of autoimmune gastritis?
- Atrophy of specialised acid secreting gastric epithelium
- Loss of specialised gastric epithelial cells
- Decreased acid secretion
- Loss of intrinsic factor
- Vitamin B12 deficiency
What is the most common type of gastritis?
Bacterial
What organism is bacterial gastritis related to?
Helicobacter pylori
What is helicobacter pylori?
- Gram negative bacterium
- Found in gastric mucus on surface of epithelium
- Produces acute and chronic inflammatory response
- Increased acid production
What can cause chemical gastritis?
- Drugs (NSAIDs)
- Alcohol
- Bile reflux
What is peptic ulceration caused by?
-Imbalance between acid secretion and mucosa barrier
What does peptic ulceration affect?
- Lower oesophagus
- Body and antrum of stomach
- First and second parts of duodenum
What bacteria is usually associated with peptic ulceration?
Helicobacter pylori which increases gastric acid
What are the complications of peptic ulceration?
- Bleeding
- Perforation
- Healing by fibrosis
What kind of bleeding can result from peptic ulceration?
- Acute haemorrhage
- Chronic anaemia
What can perforation as a result of peptic ulceration result in?
Peritonitis
What can healing by fibrosis as a result of peptic ulceration result in?
Obstruction
How common is stomach cancer?
Second commonest cancer of the alimentary tract
How does stomach cancer develop?
Develops through phases of intestinal metaplasia and dysplasia
What is stomach cancer associated with
Previous helicobacter pylori infection
What is the histology of stomach cancer?
Adenocarcinoma
How can stomach cancer spread?
- Direct (surrounding structures)
- 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%
