Esophagus - diseases

Classification? Most frequent/important ones ?

u Non-neoplastic – inflammation v course: acute/chronic - v cause: viruses (CMV, HSV), bakteria – mixed flora or TB, fungi, CHEMICAL - GERD v location: superficial/intersticial – pseudotumours u Neoplastic

Inflammation - Classification: Type of exsudate: u serous u nonpurulent – lymphoplasmocellular  purulent  fibrinous  gangrenous

Candida esophagitis

Tuberculosis

Esophagus Pseudotumours ?

Esophagus Pseudotumours Diverticula

Esophageal Diverticula – saclike bulgings of oesophageal wall 1. pharyngoesophageal (Zenker´s) pulsion diverticulum 2. thoracic – traction d. (paraesoph. pathology) 3. epiphrenic – parahiatal diverticulum

Oesophagus Neoplasms ?

NEOPLASIA – classification HISTOGENETIC v mesenchymal v epithelial v neuroectodermal v mixed, teratoma v choriocarcinoma v mesotelioma

Epithelial Tumours v surface epithelium papillomas carcinomas / papillocarcinomas v glandular epithelium adenomas adenocarcinomas v double diff. mucoepidermoid

Diseases of Stomach u inflamm. –acute –chronic v gastritis A (autoimmune, atrophy, risk. of int. ca v B (Helicobacter pylori) u pseudotumours: trichobezoar u tumours –benign: adenoma (polypose), lipoma, leiomyoma, MALIGNANT - adenoca, lymphoma

Diseases of Stomach u inflamm. –acute –chronic v gastritis A (autoimmune, atrophy, risk. of int. ca v B (Helicobacter pylori) u pseudotumours: trichobezoar u tumours –benign: adenoma (polypose), lipoma, leiomyoma, MALIGNANT - adenoca, lymphoma

Stomach & duodenum ulcers u etiology: u clinic : u complications:

Stomach & duodenum ulcers u etiol.: Helicobacer pylori, chron. gastritis B, habitual, seasonal influence, stress, smoking u clin. : pain, bleeding chron. & acute, weight loss, u complications: exsanguination, perforation, penetration, peritonitis, malignancy

Diseases of the small bowel u inflammation –acute (typhus abdominalis) –chronic v m. Crohn (autoimmune) v coeliakia –gluten enteropathy - malabsorption syndrome v m. Whipple (Tropheryma Whippeli u pseudotumours u TUMOURS – RARE –benigní adenom (polypose), lipoma, leiomyoma, carcinoid –malignant - adenoca, lymphoma

Diseases of the small bowel u Complications: motility & absorption disorders MALABSORPTION

Diseases of the large bowel u diverticulosis u inflamm. –acute (dysenteria, clostridium difficile ) –chronic v ulcerose colitis (autoimmune) v diverticulitis Complications: motility disorders u TUMOURS – VERY FREQUENT –benign adenoma (polypose), lipoma, leiomyoma, carcinoid –malignant - adenoca

Large bowel carcinoma Czech Rep. – worldwide highest incidence Predisp. factors: genetic, lifestyle u Symptomes: –right half – silent for a long time Bleeding occult or manifest. Weight loss. Passage disturbances. u Diagnosis: –imaging, endoscopy, BIOPSY u Complications: –stenosis or perforation, peritonitis, M –METASTASES

Large bowel carcinoma Czech Rep. – worldwide highest incidence Predisp. factors: genetic, lifestyle u Symptomes: right half – silent for a long time Bleeding occult or manifest. Weight loss. Passage disturbances. u Diagnosis: imaging, endoscopy, BIOPSY u Complications: stenosis or perforation, peritonitis, METASTASES

ILEUS - bowel obstruction u MECHANICAL –obstruction (tumour, stone, parasites, foreign body … –strangulation u DYNAMICAL –paralytic (peritonitis) –spastic (inervation disturbances) u combined…. Def.: disruption of the normal propulsive ability of the GIT (stop of the passage )

Diseases of Pancreas u inbor –mukoviscidosis – cystic pancreatofibrosis hemochromatosis - MALABSORPTION u acquired –inflammation v acute – hemorrhagic necrosis v chronic – in etanol abusers nodular- pseudotumour and precancerosis –Neoplasms v exocrine – carcinomas v endocrine – nesidiomas (e.g. insulinoma) – classified mostly as low grade neuroendocrine carcinomas, less frequently high grade

Mucoviscidosis cystic fibrosis, fibrocystic disease u autosomal recessive 7th chromosome 2-5% heterozygotic carriers in the caucasian population u abnormal viscosity of mucin –disturbance of the membrane associated protein that serves as a calcium channel v increased concentration of chloride in sweat v decreased water content in excocrine secrets

Mucoviscidosis cystic fibrosis, fibrocystic disease Complications: – meconium ileus – steatorrhea – pancreatic fibrosis & cysts – bronchitis, bronchopneumonia, bronchiectasia – sterility