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