الرحيم الرحمن الله بسم

GIT Diseases

ByDr. Ghada Ahmed

Lecturer of PathologyBenha Faculty of Medicine

Objectives Discuss different

diseases of the esophagus

Hiatal herniaEsophgeal

varicesEsophagitisBarrett’s

esophagusTumors Causes of

dysphagia

Discuss different diseases of the stomach

Pyloric stenosisGastritis Gastric ulcersTumorsCauses of

haematemesis

Diseases of the esophagus

I. Hiatal hernia

Sliding H Paraesophageal H

II. Esophageal varicesCauses

III. Esophagitis

Causes: Reflux Gastric intubationIngestion of irritant substanceInfection (viral, bact, fungal)Cytotoxic/ radiation ttt

Reflux esophagitis:

Def CausesMorphology Complications: (PU - Perforation- Barrett’s-

Precancerous)

IV. Barrett’s esophagus

V. Esphageal tumors

Esophageal tumors

Benign

Epithelial Mesenchymal

Malignant

Epithelial Mesenchymal

Carcinoma of the esophagus

Squamous cell carcinoma (90%):

PFSitesMorphology

Adenocarcinoma

PFSiteMorphology

Carcinoma of the esophagus

Effects of esophageal carcinomaDysphagiaCachexiaHematemesisTracheo-esophageal fistula

Spread:

VI. Dysphagia

In the wall (stricture)

In the lumen (obstruction)

Pressure from outside

Diseases of the stomach

Gastric mucosal barrier

I. Pyloric stenosisCongenitalAcquired

II. Gastritis

Acute Chronic

Chronic superficial gastritis

Chronic atrophic gastritis

Acute gastritis

Causes:NSAIAlcoholSmoking InfectionStress Cancer chemotttSuicide attempts

Acute gastritis

Chronic gastritis

DefCauses (AI, H.pylori, smoking,

alcohol)Types:

Chronic superficial gastritis

Chronic Atrophic gastritisGrossm/pGastric atrophyMetaplasia

H. pylori

PathogenesisEffects

III. Gastric ulcer

Acute gastric ulcer

Peptic ulcer (chronic gastric ulcer)

DefSites P F

Pathogenesis of peptic ulcer

Damaging forces:

e.g. H.pyloriGenetic, hormonal

EnviromentalStress

Mucosal defenses:

MucinBicarbonate secEpithelial barrier

Peptic ulcer (morphology)

Peptic ulcer (morphology)

Complications Bleeding (hematemesis- melena)

Perforation

Fibrosis----- (stenosis)

Malignant transformation

IV. Tumors of stomach

Benign

Epithelial :

Adenoma

Mesenchymal

Leiomyma, fibroma, lipoma,

GIST

Malignant

Epithelial: *Adenocarc. *Mucinous carcinoma, *Signet ring carcinoma,

*Undifferentiated carcinoma

Mesodermal

Lymphosarc.Carcinoid

LymphomaGIST

Gastric adenoma (polyp)

Gastrointestinal stromal tumors(GIST)

Definition:(interstitial cells of Cajal)

Age > 40 ysSites 60% gastricMorphologyEffects

Morphology of GIST

Gastric carcinomaIncidence old male gp A

Aetiology:

PF : Diet as nitrates Dried salted fish& meat Decreased intake of fresh veg& fruits:

Precancerous lesions(gastritis- ulcer- polyp)

Gastric carcinoma (sites)

50%

25%

25%

Gastric carcinoma/ Gross1- polypoid 2-ulcerative

3- infiltrative(Linitis plastica/ leather bottle st)

Gastric carcinoma m/p

1-Adenocarc.

2-Mucinous carc.

3-Signet ring carc.

Spread & metastasesDirect spreadLymphatic spreadBlood spreadTranscoelomic spread

Effects & Complications(bleeding-obstruction-

hypoHCL- cachexia)

V. Haematemeis DefintionCauses

Haematemesis

Local causes

1- esophgeal 2- gastric 3-

duodenal

General causes

Blood diseases &

vitamin def.

Next

Diseases of small intestine