Zusammenfassung der Ressource
Stomach
- Gastroschisis
- Congenital malformation of abd wall exposing abd contents
- Omphalocele
- Persistent herniation of the bowel into the umblical cord
- due to failure of the herniated intestines to return
- Contents are covered by peritoneum
- Abd contents in a bubble
- Pyloric stenosis
- Congenital stenosis of pyloric sphincter
- Seen more commonly in
males
- Clinical features
- Commonly presented after 2 weeks of birth
- Projectile nonbilous vommiting
- Visible peristalisis
- Olive like mass in abdomen
- Treatment is Myotomy
- Acute Gastritis
- Acidic Damage to stomach mucosa
- Imbalance between mucosal defences and acidic imbalance
- Mucin layer by foveolar cells
- Bicarbonate secretion by surface epithelium
- Normal blood supply which takes up leaked acid
- Risk Factors
- Severe Burn (curling ulcer)
- NSAIDs
- Alcohol
- Chemotherapy
- Increased ICP
- Increasead stimulation of vagus nerve > acid production
- Shock (multiple stress ulcers)
- Chronic Gastritis
- Chronic Inflammation of Gastric mucosa
- Two types
- Chronic Autoimmune
- Autoimmune destruction of gastric parietal cells
- Parietal cells are located in body and fundus
- Pathogenesis mediated by T Cells (Type IV)
- Diagnosis: Antibodies against Parietal Cells and IF
- Clinical feaures
- Atrophy of mucosa
- intestinal metaplasia
- Achlorhydria
- Megaloblastic anemia due to lack if IF
- risk of gastric adenocarcinoma
- Chronic H.pylori
- Most common form of Gastritis
- H.pylori secretes ureases and proteases
- Antrum is most common site
- Clinical Features
- MALT
- Abdominal Pain
- Gastric Adenocarcinoma risks
- Triple Therapy
- Resolves Gastric ulcer
- Negative urea breath & lack of stool antigen to confirm eradication of H.pylori
- Reverses intestinal metaplasia
- Peptic Ulcer Disease
- Solitary mucosal ulcer in duodenum (90%) or in gastric mucosa (10%)
- Two types
- Duodenal
- always due to H.pylori rarely due to ZE
- epigastric pain improving with meals
- Hypertrophy of Brunner glands on Endo
- Rupture of Anterior ulcer- Gastroduodenal Artery bleeding
- Posterior ulcer Rupture - Acute pancreatitis
- Never Malignant
- Gastric
- H. Pylori (75%
- NSAID & bile reflux
- Located usually on the antrum
- Pain worsens after meal
- Rupture leads to bleed from Left epigastric A
- May turn into malignant
- Large irregular with heaped up margins
- Benign are generally small (<3cm)
- Punched out margins with radiating folds of mucosa