Rohal.peptic ulcer
-
Upload
rohal -
Category
Health & Medicine
-
view
2.897 -
download
5
description
Transcript of Rohal.peptic ulcer
![Page 1: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/1.jpg)
"Each time you are honest and "Each time you are honest and conduct yourself with honesty, a conduct yourself with honesty, a success force will drive you toward success force will drive you toward greater success. Each time you lie, greater success. Each time you lie, even with a little white lie, there are even with a little white lie, there are strong forces pushing you toward strong forces pushing you toward failure."failure."
aleealee
![Page 2: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/2.jpg)
Pathology of Peptic Ulcer
By ali azizBy ali aziz
![Page 3: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/3.jpg)
Normal Stomach
![Page 4: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/4.jpg)
Esophagus & Stomach Normal
![Page 5: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/5.jpg)
Definition:
Ulceration (breach in mucosa) due to acid & pepsin attack – peptic ulcer.
Deeper than just mucosa
Single, punched out, clean base – why?
![Page 6: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/6.jpg)
Etiology: (study of causes)
Helicobacter pylori infection.(bacteria)
Hyperacidity –
Drugs - anti-inflammatory (NSAIDs) & Corticostroids.
Cigarette smoking, Alcohol,
Rapid gastric emptying
Personality and stress
![Page 7: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/7.jpg)
H. Pylori organisms- silver st.
![Page 8: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/8.jpg)
Pathogenesis: : (process)
Helicobacter pylori infection
Colonization of gastric mucous
Urease ammonia neutralization of acid Rebound acid production.
Protease – Mucous break down.
Weak mucosal resistance
Acid & Pepsin digestion of mucosa
Chronic Ulceration
![Page 9: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/9.jpg)
Etiology of PUD
Normal
Increased Attack Hyperacidity
Weak defense Helicobacter pylori* Stress, drugs, smoking
![Page 10: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/10.jpg)
Helicobacter pylori:
Most common infection in the world (20%)
10% of men, 4% women develop PUD *
Positive in 70-100% of PUD patients.
H.pylori related disorders:Chronic gastritis – 90%Peptic ulcer disease – 95-100%Gastric carcinoma – 70%Gastric lymphomaReflux Oesophagitis.Non ulcer dyspepsia
![Page 11: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/11.jpg)
Peptic Ulcer Morphology:
90% ulcers in first portion of duodenum or lesser curvature of stomach(4:1).
80 to 90% cases single ulcer. Round Small ulcers with sharply punched out edges*
Small <2cm, clean base*.
Microscopy: 4 zones. Superficial necrotic layer. Inflammatory cells zone. Granulation tissue zone Collagenous scar layer.
![Page 12: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/12.jpg)
Complications:
Bleeding – Chronic-IDA, Acute, Massive
Fibrosis, Stricture obstruction – pyloric stenosis.
Perforation – Peritonitis- emergency.
Gastric carcinoma. (not duodenal ca)
![Page 13: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/13.jpg)
Acute Esophagitis & Gastritis
![Page 14: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/14.jpg)
Gastric peptic ulcer:
![Page 15: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/15.jpg)
Gastric peptic ulcer:
![Page 16: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/16.jpg)
Gastric Ulcer
![Page 17: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/17.jpg)
Duodenal Peptic Ulcer
![Page 18: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/18.jpg)
Gastric Ulcer
![Page 19: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/19.jpg)
Peptic ulcer - Endoscopy
![Page 20: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/20.jpg)
Gastric Ulcer
![Page 21: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/21.jpg)
Gastric Ulcer
![Page 22: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/22.jpg)
Gastric UlcerPunched out ulcer
Clean base
Small single
Radiating mucosal folds.
Benign ulcer.
No tumor.
![Page 23: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/23.jpg)
Peptic Ulcer
![Page 24: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/24.jpg)
Peptic Ulcer Microscopy:
![Page 25: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/25.jpg)
Perforation:
![Page 26: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/26.jpg)
Acute Esophagitis & Gastritis
![Page 27: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/27.jpg)
Fungating
![Page 28: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/28.jpg)
Linitis Plastica – Schirrhous Carcinoma.
![Page 29: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/29.jpg)
Helecobacter pylori
Gram negative, Spiral bacilli
Spirochetes
Do not invade cells – only mucous
Breakdown urea - ammonia
Break down mucosal defense
Chronic Superficial inflammation
![Page 30: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/30.jpg)
PUD - Diagnosis
Endoscopy
Barium meal – contrast x-ray
Biopsy – bacteria & malignancy
H.Pylori:Endoscopy cytologyBiopsy – Special stainsCulture - difficultUrease Breath test.
![Page 31: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/31.jpg)
Points to Remember:
A peptic ulcer is a sore in the lining of the stomach or duodenum due to attack by acid & Pepsin.
The major cause - H. pylori bacterium. Others are NSAIDs. spicy food, stress are risk factors.
H. pylori can be transmitted from person to person through close contact
A combination of antibiotics and H pump inhibitors is the most effective treatment.
![Page 32: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/32.jpg)
Helecobacter pylori
![Page 33: Rohal.peptic ulcer](https://reader033.fdocuments.us/reader033/viewer/2022052822/554b27fbb4c905ce088b4894/html5/thumbnails/33.jpg)
“You get ulcer, not from what you eat, but from what’s
eating you..!”