Scribd
Upload
49 views

Gastrointestinal Disorders: Congenital Abnormalities

This document summarizes various gastrointestinal disorders that can affect the esophagus, stomach, small intestine, and colon. It describes congenital abnormalities and acquired conditions such as esophageal atresia, achalasia, gastroesophageal reflux disease, peptic ulcers, H. pylori infection, gastric cancer, celiac disease, inflammatory bowel disease, diverticulosis, colon polyps, and colon cancer. It also briefly discusses hernias, appendicitis, and mechanical disorders such as intussusception and Meckle's diverticulum.

Uploaded by

Asadullah Yousafzai
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
49 views

Gastrointestinal Disorders: Congenital Abnormalities

This document summarizes various gastrointestinal disorders that can affect the esophagus, stomach, small intestine, and colon. It describes congenital abnormalities and acquired conditions such as esophageal atresia, achalasia, gastroesophageal reflux disease, peptic ulcers, H. pylori infection, gastric cancer, celiac disease, inflammatory bowel disease, diverticulosis, colon polyps, and colon cancer. It also briefly discusses hernias, appendicitis, and mechanical disorders such as intussusception and Meckle's diverticulum.

Uploaded by

Asadullah Yousafzai
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
You are on page 1/ 11

3/7/2013

Gastrointestinal Disorders

Congenital Abnormalities

Disorders of the Esophagus

Types

Stenosis
Atresia
Fistula

Newborn
aspirates
while feeding.
Pneumonia

Achalasia

Not an easy repair

Lack of relaxation of cardiac


sphincter

Inflammation leads to

The default condition is


contraction
Scarring and
Loss of ganglia cells

Decreased innervation
means no relaxation
Leads to retention of food,
inflammation and more
scarring

3/7/2013

Esophageal Diverticulae

Esophageal Scarring and Ring formation

Inflammation leads to

Scarring and
Loss of ganglia cells

Decreased innervation
means no relaxation
Leads to retention of
food, inflammation
and more scarring

Hiatal Hernia

Traction
Pulsion
Magicians

Incompetence of
diaphragmatic opening
Portion of stomach is in
thorax
Sliding type ->
Leads to

Hiatal Hernia

Rolling type
May lead to gastric
mucosal ischemia.
Ulceration
GI bleeding

Regurgitation of food
Acid reflux
Ulceration

Esophagitis

Inflammation of
mucosa
Lots of causes

Reflux of stomach
acid ->
Infectious agents

Metaplasia of
squamous epithelium

Cytotoxic agents
Autoimmune

Bacteria
Viral (HIV)
Fungal (HIV)

Barretts Change

Columnar epi
Repeat injury

Reflux

Indicates serious or
prolonged damage
Cancer risk?

3/7/2013

Esophageal Varices

Barretts Change

Dilation of esophageal
veins, distal 1/3.
Increased venous
portal pressure.

Esophageal Varices

Esophageal Cancer

Cirrhosis

Life threatening
hemorrhage

Esophageal Varices

Esophageal Cancer

Squamous cell
Repeat irritation
Tobacco
Invasive
Barretts change

Adenocarcinoma

3/7/2013

Disorders of the Stomach

Gastritis

Acute

Chronic Gastritis

Polys
ETOH
H. pylori
Pain
Bleeding

Chronic

Mucosal atrophy
Mucin cell hyper
Lymphocytes
Autoimmune
B-12 deficiency

Peptic Ulcer

Helicobacter pylori

Action of digestion
Balance between good
and evil
H. pylori
NSAIDs

Complications

Gram negative rod


Lives on the epithelial
surface.
Urease destroys mucus
Increases acid secretion
Reduces duodenal bicarb
Intensifies inflammatory
response
Immunogenic

Aspirin
Bleeding
Perforation
Penetration
Scarring

Zollinger-Ellison

Gastrin secreting tumor

3/7/2013

Good and Evil

Stress Ulcers

This means stress, not


surprise (pop quiz)
Trauma

Vascular mediated

Gastric Cancer

Major
Head injury
Burns
Rearranged blood flow

Multiple erosions
Confined to mucosa
Can bleed seriously

Linitis Plastica

Adenocarcinoma
Risk factors

Nitrites
Smoked foods
Chronic gastritis with
H. pylori

Small Bowel Disease

3/7/2013

Mechanical Problems

Intussesception

Meckles Diverticulum

Problems with a Meckles

Congenital diverticulum of the distal small bowel.

2 kinds of mucosa
2 feet from the ileocecal valve.
2 inches in size.
Twice as common in males

Vascular Related

Bowel infarction
Hemorrhagic

Bowel infarction

Venous
Arterial

Septic shock
Very painful

3/7/2013

Non-infectious Inflammatory

Infectious Enteritis

Many agents infect the small bowel.

Viral
Bacteria

Salmonella

Parasites

Unicellular

Giardia

Multicellular

Worms

Crohns Disease

Crohns disease

Transmural inflammation
Scarring and stricture formation
Fistulae

Granulmatous enteritis
Transmural inflammation
No known infectious agent
Granulomas in about 40%
Fistula formation
Relapsing
Small bowel or colon
Ethnicity
No significant increased risk
of cancer (minimal at best)

Crohns Microscopic

Granulomas about 40% of the time.


Transmural all the time

Gluten Enteropathy

3/7/2013

Hirschprungs
Disease

Colonic Disease

Ulcerative Colitis

Ulcerative Colitis

Mucosal

Aganglionic segment
Peristalsis stops
Dilation of colon back
stream of the
defective segment.
Remove distal portion
that looks healthy.
Look for ganglia.

Crypt abscesses

Autoimmune element?
Starts in rectum and
works its way back.
Pseudopolyps
Toxic megacolon
Increased cancer risk

Crypt Abscess

Diverticulosis

3/7/2013

Diverticulitis

Colonic Polyps

Familial
Polyposis

Colonic Polyps

Familial Polyposis

Millions of
adenomatous polyps
Genetic predisposition
100% of chance of
cancer

Familial Polyposis

3/7/2013

Colon Cancer

Genetics of Colon Cancer

Right and left side


have different
presentations

Right = anemia
Left = bowel changes

Contributing factors

Genetics
Dietary fiber
Dietary fat

Spread

Liver
Lymph nodes

Colon Cancer

Appendicitis

Inguinal Hernia

Obstruction of mouth
of appendix

Appendicitis

Fecolith
Enlarged lymph nodes

Bacteria proliferate
and invade wall.
Rupture

Peritonitis
Abscess

10

3/7/2013

Direct Abdominal
Hernia

11

You might also like