© 2004 Current Medicine Group Ltd FISIOLOGÍA DIGESTIVA (BCM II) Clase 7: Gastritis y H. pylori Dr. Michel Baró A.

© 2004 Current Medicine Group Ltd Gastritis: overview of anatomy and histology

© 2004 Current Medicine Group Ltd Normal fundic mucosa

© 2004 Current Medicine Group Ltd General classification of gastritis

© 2004 Current Medicine Group Ltd Endoscopic erosive gastritis

© 2004 Current Medicine Group Ltd Erosive gastritis

© 2004 Current Medicine Group Ltd Gastritis: anti inflamatorios no esteroidales y aspirina (“Gastropatía”)

© 2004 Current Medicine Group Ltd Acute erosive hemorrhagic gastritis

© 2004 Current Medicine Group Ltd Endoscopic gastritis: alcohol Gastropatía hemorrágica alcohólica

© 2004 Current Medicine Group Ltd Alcoholic hemorrhagic gastritis: histologic features Epitelio intacto Bandas Hemorrágicas interglandulares Edema Ausencia de Infiltrado inflmatorio

© 2004 Current Medicine Group Ltd Chronic gastritis: nonspecific gastritis (a) TABLE A. CHRONIC GASTRITIS: NONSPECIFIC GASTRITIS - HELICOBACTER PYLORI

© 2004 Current Medicine Group Ltd Chronic gastritis: nonspecific gastritis (b)

© 2004 Current Medicine Group Ltd Nonerosive nonspecific gastritis: activity (a) Gastritis crónica superficial, activa (infiltrado neutrófilos y mononucleares)

© 2004 Current Medicine Group Ltd Nonerosive nonspecific gastritis: activity (b) Gastritis crónica superficial (infiltrado sólo mononucleares)

© 2004 Current Medicine Group Ltd Foveolar hyperplasia

© 2004 Current Medicine Group Ltd Intestinal metaplasia

© 2004 Current Medicine Group Ltd Endocrine consequences of chronic atrophic gastritis

© 2004 Current Medicine Group Ltd Enterochromaffin-like cell hyperplasia

© 2004 Current Medicine Group Ltd Distributions of nonerosive, nonspecific gastritis Se asocia a la presencia de H. pylori Úlcera duodenal 90% Úlcera gástrica 50-80% Anemia perniciosa Gastritis auto-inmune

© 2004 Current Medicine Group Ltd Serum pepsinogens and chronic gastritis

© 2004 Current Medicine Group Ltd Chronic gastritis: specific or distinctive gastritis

© 2004 Current Medicine Group Ltd Morphology and taxonomy

© 2004 Current Medicine Group Ltd Electron micrographs from Helicobacter pylori-infected patient (A)

© 2004 Current Medicine Group Ltd Electron micrographs from Helicobacter pylori-infected patient (B)

© 2004 Current Medicine Group Ltd Prevalence by age and country of origin (A)

© 2004 Current Medicine Group Ltd Prevalence by age and country of origin (B)

© 2004 Current Medicine Group Ltd Prevalence by ethnic group

© 2004 Current Medicine Group Ltd Clustering of organism within families

© 2004 Current Medicine Group Ltd Histologic stains (A) Warthin.Starry

© 2004 Current Medicine Group Ltd Histologic stains (B) Giemsa

© 2004 Current Medicine Group Ltd Histologic stains (C) Acridina

© 2004 Current Medicine Group Ltd Histologic stains (D) Gimenez

© 2004 Current Medicine Group Ltd Histologic stains (E) Hematoxilina-eosina

© 2004 Current Medicine Group Ltd Urease

© 2004 Current Medicine Group Ltd Urea breath tests (C13 and C14)

© 2004 Current Medicine Group Ltd Rapid urease tests

© 2004 Current Medicine Group Ltd Tests for diagnosis of Helicobacter pylori can be categorized

© 2004 Current Medicine Group Ltd Association of Helicobacter pylori with gastrointestinal disease

© 2004 Current Medicine Group Ltd Helicobacter pylori and chronic active gastritis

© 2004 Current Medicine Group Ltd Antral (type B) gastritis 95% porta H. pylori

© 2004 Current Medicine Group Ltd Helicobacter pylori's initiation of mucosal inflammation

© 2004 Current Medicine Group Ltd Pathway of Helicobacter pylori induction

© 2004 Current Medicine Group Ltd Lymphoid follicle

© 2004 Current Medicine Group Ltd Gastric metaplasia

© 2004 Current Medicine Group Ltd Histology of gastric metaplasia (A) (duodeno)

© 2004 Current Medicine Group Ltd Histology of gastric metaplasia (B)

© 2004 Current Medicine Group Ltd Helicobacter pylori and peptic ulcer disease

© 2004 Current Medicine Group Ltd Helicobacter pylori and peptic ulcer disease

© 2004 Current Medicine Group Ltd Helicobacter pylori and serum gastrin concentrations

© 2004 Current Medicine Group Ltd Effect of Helicobacter Pylori eradication

© 2004 Current Medicine Group Ltd H. Pylori y carcinoma: Epidemiology and geographic data

© 2004 Current Medicine Group Ltd Stored sera were analyzed for Helicobacter pylori

© 2004 Current Medicine Group Ltd Characteristics of gross pathology

© 2004 Current Medicine Group Ltd Relationship of Helicobacter pylori to gastric cancer

© 2004 Current Medicine Group Ltd Non-Hodgkin's lymphoma of the stomach

© 2004 Current Medicine Group Ltd Dense lymphoid infiltrate Hiperplasia Folicular

© 2004 Current Medicine Group Ltd Lymphoepithelial lesion Linfoma MALT (linfocitos B)

© 2004 Current Medicine Group Ltd Cytokeratin stains (A) Normal

© 2004 Current Medicine Group Ltd Cytokeratin stains (B) MALT lymphoma Linfoma MALT (linfocitos B)

© 2004 Current Medicine Group Ltd Regression of gastric mucosa-associated lymphoid tissue

© 2004 Current Medicine Group Ltd FIN