Upper Gastrointestinal Pathology Kristine Krafts, M.D. GI Pathology - - PowerPoint PPT Presentation

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Upper Gastrointestinal Pathology Kristine Krafts, M.D. GI Pathology - - PowerPoint PPT Presentation

Mar 30, 2024 183 likes •506 views

Upper Gastrointestinal Pathology Kristine Krafts, M.D. GI Pathology Outline Esophagus Stomach Intestine Liver Gallbladder Pancreas GI Pathology Outline Esophagus Hiatal hernia Mallory-Weiss syndrome Barrett

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Upper Gastrointestinal Pathology

Kristine Krafts, M.D.

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GI Pathology Outline

  • Esophagus
  • Stomach
  • Intestine
  • Liver
  • Gallbladder
  • Pancreas
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SLIDE 3

GI Pathology Outline

  • Esophagus
  • Hiatal hernia
  • Mallory-Weiss syndrome
  • Barrett esophagus
  • Carcinoma
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Normal esophageal-gastric junction

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  • Dilated portion of stomach protrudes

above diaphragm

  • Common! Usually asymptomatic.
  • Heartburn, reflux esophagitis
  • Danger: ulceration, bleeding

Hiatal Hernia

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Sliding (L) and rolling (R) hiatal hernias

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  • GE junction tears
  • Severe vomiting (chronic alcoholics)
  • Symptoms: bleeding, pain, infection
  • Treatment: cauterization
  • Prognosis: usually heals; sometimes fatal

Mallory-Weiss Syndrome

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Mallory-Weiss tears

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Mallory-Weiss tears

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  • Replacement of squamous epithelium by

columnar epithelium with goblet cells

  • Complication of long-standing reflux esophagitis
  • Danger: 30-100x risk of adenocarcinoma
  • Treatment: screen for high-grade dysplasia

Barrett Esophagus

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Normal esophagus (L) and Barrett esophagus (R)

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Barrett esophagus

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Barrett esophagus

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Adenocarcinoma

  • Commonest type in US
  • Risk factor: Barrett

esophagus

  • Distal 1/3 of esophagus
  • Symptoms: insidious onset;

late obstruction

Squamous cell carcinoma

  • Commonest type worldwide
  • Risk factors: esophagitis,

smoking, alcohol, genetics

  • Middle 1/3 of esophagus
  • Symptoms: insidious onset;

late obstruction

Esophageal Carcinoma

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Adenocarcinoma of esophagus

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Squamous cell carcinoma of esophagus

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GI Pathology Outline

  • Esophagus
  • Stomach
  • Gastritis
  • Ulcers
  • Carcinoma
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  • Mucosal inflammation
  • Asymptomatic, or epigastric pain
  • Causes: H. pylori, autoimmune, NSAIDs
  • Danger: intestinal metaplasia

Gastritis

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Gastritis

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Chronic gastritis

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Helicobacter pylori organisms

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  • Erosion of mucosa into submucosa
  • Causes: H. pylori, NSAIDs
  • Symptoms: epigastric pain
  • Danger: bleeding, perforation

Ulcer

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Ulcer

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Intestinal type

  • Arises in intestinal

metaplasia

  • Risk factors: chronic

gastritis, bad diet

  • Glandular morphology
  • Generally asymptomatic

Diffuse type

  • Arises from gastric glands
  • Risk factors undefined
  • Signet ring morphology
  • Generally asymptomatic

Gastric Carcinoma

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Intestinal-type gastric carcinoma: glands

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Diffuse gastric carcinoma: signet ring cells

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Signet ring cell

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Gastric carcinoma presenting as mass

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Gastric carcinoma presenting as ulcer

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Gastric carcinoma presenting as linitis plastica