Upload
alban-walsh
View
227
Download
4
Embed Size (px)
Citation preview
Esophagus- diseases
Classification?
Most frequent/important ones ?
Non-neoplastic
– inflammation course: acute/chronic - cause: viruses (CMV, HSV), bakteria –
mixed flora or TB, fungi, CHEMICAL - GERD
location: superficial/intersticial
– pseudotumoursNeoplastic
Inflammation - Classification:
Type of exsudate: serous 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 mesenchymal epithelial neuroectodermal mixed, teratoma choriocarcinoma mesotelioma
Epithelial Tumours surface epithelium
papillomas carcinomas / papillocarcinomas
glandular epithelium adenomas adenocarcinomas
double diff.
mucoepidermoid
Diseases of Stomach inflamm.
– acute– chronic
gastritis A (autoimmune, atrophy, risk. of int. ca B (Helicobacter pylori)
pseudotumours: trichobezoar tumours
– benign: adenoma (polypose) , lipoma, leiomyoma, MALIGNANT - adenoca, lymphoma
Diseases of Stomach inflamm.
– acute– chronic
gastritis A (autoimmune, atrophy, risk. of int. ca B (Helicobacter pylori)
pseudotumours: trichobezoar tumours
– benign: adenoma (polypose) , lipoma, leiomyoma, MALIGNANT - adenoca, lymphoma
Stomach & duodenum ulcers
etiology: clinic : complications:
Stomach & duodenum ulcers
etiol.: Helicobacer pylori, chron. gastritis B, habitual, seasonal influence, stress, smoking
clin. : pain, bleeding chron. & acute, weight loss,
complications: exsanguination, perforation, penetration, peritonitis, malignancy
Diseases of the small bowel inflammation
– acute (typhus abdominalis)– chronic
m. Crohn (autoimmune) coeliakia –gluten enteropathy - malabsorption syndrome m. Whipple (Tropheryma Whippeli
pseudotumours TUMOURS – RARE
– benigní adenom (polypose) , lipoma, leiomyoma, carcinoid– malignant - adenoca, lymphoma
Diseases of the small bowel
Complications: motility & absorption disorders
MALABSORPTION
Diseases of the large bowel diverticulosis inflamm.
– acute (dysenteria, clostridium difficile )– chronic
ulcerose colitis (autoimmune) diverticulitis
Complications: motility disorders TUMOURS – VERY FREQUENT
– benign adenoma (polypose) , lipoma, leiomyoma, carcinoid
– malignant - adenoca
Large bowel carcinoma Czech Rep. – worldwide highest incidence Predisp.
factors: genetic, lifestyle
Symptomes:
– right half – silent for a long time Bleeding occult or manifest. Weight
loss. Passage disturbances.
Diagnosis:
– imaging, endoscopy, BIOPSY
Complications:
– stenosis or perforation, peritonitis, M
– METASTASES
Large bowel carcinoma Czech Rep. – worldwide highest incidence
Predisp. factors: genetic, lifestyle
Symptomes: right half – silent for a long time
Bleeding occult or manifest. Weight loss.
Passage disturbances.
Diagnosis: imaging, endoscopy, BIOPSY
Complications: stenosis or perforation,
peritonitis, METASTASES
ILEUS - bowel obstruction
MECHANICAL– obstruction (tumour, stone, parasites, foreign body …
– strangulation
DYNAMICAL– paralytic (peritonitis)– spastic (inervation disturbances)
combined….
Def.: disruption of the normal propulsive ability of the GIT (stop of the passage )
Diseases of Pancreas inbor
– mukoviscidosis – cystic pancreatofibrosis hemochromatosis - MALABSORPTION
acquired– inflammation
acute – hemorrhagic necrosis chronic – in etanol abusers nodular- pseudotumour and
precancerosis
– Neoplasms exocrine – carcinomas endocrine – nesidiomas (e.g. insulinoma) – classified mostly as low
grade neuroendocrine carcinomas, less frequently high grade
Mucoviscidosis cystic fibrosis, fibrocystic disease
autosomal recessive 7th chromosome2-5% heterozygotic carriers in the caucasian
population abnormal viscosity of mucin
– disturbance of the membrane associated protein that serves as a calcium channel
increased concentration of chloride in sweat decreased water content in excocrine secrets
Mucoviscidosis cystic fibrosis, fibrocystic disease
Complications:– meconium ileus– steatorrhea– pancreatic fibrosis & cysts– bronchitis, bronchopneumonia,
bronchiectasia– sterility