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What parts of the Stomach secretes:
Acid?
Pepsin?
Gastrin?
Has Mucus Cells?
- - Fundus
- - Fundus
- -Antrum
- -Antrum and Cardia
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What is the differenct in the Histplpgy of the stumach?
The is an Extra 3rd Layer of Smooth Muscle
- Mucosa
- Submucosa
- Muscularis
- Serosa
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What is Pyloric stenosis?
What is the Major Symptom?
Sex & age?
Genetic?
Pyloric Sphincter is not open enough. Smooth muscle is hypertrophied
- - Projectile vomiting in the first months (2-8 weeks) of life.
- - White Males
- - Yes, this may be inherited
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What is Pancreatic Heteropia?
What does it present as?
location?
- It is a congenital Defect.
- Presents as a mass in the stomach area
- Located commonly in the Submucosa of the Antral or pylorus
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 What is this???
Pancreatic Heterotopia in the Stomach. A congenital Defect.
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What is Acute Gastritus?
Is it associated with Infection?
What are the Thee types?
It is acute inflammation in the stomach
Rarely associated with infection
- 1. Acute Hemorrhagic (erosive) Gastritis
- 2. Stress Ulcers (Ulceration)-- (Burns, Shock)
- 3. Reactive Gastropathy--- repair process due to repeated acute episodes
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What are some causes of Acute Hemorrhagic Erosive Gastritis.
- NSAIDS
- Heavy alcohol
- Heavy Smoking
- Stress
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This is Acute Gastritis
- a) see alot of PMNs
- b) See Punctate erosions
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What is Chronic Gastritis?
What are the 2 Causes?
Presence of Chronic Imflammation with atrophy and metaplasia.
1. Chronic Gastritis (90%)--- usually due to H. pylori.
2. Autoimmune atrophic gastritis (10%)---- may be premalignant
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What disease are associated with H. Pylori?
- Chronic Gastritus
- Peptic Ulcer disease
- Gastric Carcinoma
- Gastric MALT lymphoma
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What is this?
- H. Pylori infection
- NO TISSUE INVASION
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Chronic Gastritis
- See replacement of Epithelium by intestinal Metaplasia.
- See LYMPHOCYTES and Plasma cells
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What chages will you see associated with H. Pylori?
Acutly?
Chronically?
Acute: See PMN's which is the hallmark of a continued infection.
Chronic: See difuse lymphocytes and PLASMA cells. Lymphoid follicals = Severe ongoing infection
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Pathologic Changes Associated with H. Pylori Chronic Gastritis.
- Metaplasia
- Mucosal Atrophy
- Peptic Ulcer Disease
- Dysplasia--> adenocarcinoma sequence
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What is Peptic Ulcer disease?
What is an ulcer
Where is the Erosion
Location
Sex
Causes
Chronic, Solitary Lesions. Occur in ANY part of the GIT.
- -Ulcers through the Muscularis Mucosae
- -Erosion only on the mucosae
- -Duodenal more common than gastric
- - Males
- - Most due to H. Pylori
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IN a peptic ulcer, you will see layers of ?
Necrosis, Inflammation, granulation, and a scare.
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What is this?
- Peptic Ulcer
- sharply " Punched out " appearance.
- margins are NOT elevated
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What is going on in Autoimmune Gastritis?
-Associated with?
- what might you see?
-When it is sever it is associated with?
- what test do we used to esses the B12 deficiency?
Hypochlorhyria (less acid)--> atrophic change , may have G-Cell hyperplasia and hypergastrinemia.
-increased risk of Gastric Cancer and carcinoid tumors. See in association with other autoimmune diseases
- - see various autoantibodies (parietal cell, ATPase, Intrinsic Factor, gastrin receptor)
- - Pernicious Anemia
- - Schilling test
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What tests do you run for Autoimmue gastritis?
- antibodies
- look ofr other autoimmunities
- Atrophic Glossitis
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What is two diseases are Hypertrophic Gastropathies?
What can they mimic?
What do they have?
Menetrier disease and Zollinger-Ellison
minic Carcinoma or lymphoma - can have sever peptic ulcer disease
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What do they have?
Hypertrophic Gastropathy
Note: The Thickened Gastric Folds
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What do you see in Menetriers disease?
TGF-Alpha
Protein loosing Enteropathy (see skinny people)
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What do you see in Zollinger Ellison Syndrome
- - Gastric Producing tumors
- -5 times the Numer of Parietal cells
- -HIGH< HIGH Gastrin levels
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What are the two main Benign Gastric Tumors?
Hyperplastic Polyps
Adenomatous Polyps
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Hyperplastic Polyps
- Reactive
- Benign
- 90 % of Gastric polyps
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Adenomatous Polyps
Have Poloiferative dysplastic Epithelium
- start in Chronic Gastritis
- make up 5% of gastric polyps
- associated with carcinomas
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