内科学 消化系统总论课件.pptVIP

Digestive SystemIntroduction Prof. Ji yao Wang Characteristics of Digestive System Immune organ Gastrointestinal-associated lymphoid tissue, GALT Not only a digestive organ but also endocrine organ pancreas gastrin 胃泌素 glucagon 胰高糖素 somatostatin 生长抑素 VIP 血管活性肠肽 insulin 胰岛素 Structure /function and diseases ?inflammation 炎症 ?Ulcer 溃疡 ?bleeding 出血 ?perforation 穿孔 ?neoplasm 肿瘤 ?functional disturbances 功能失调 Classification of GI Diseases Impaired Digestion and Absorption Biliary obstruction, Chronic pancreatitis Altered Secretion Zollinger-Ellison syndrome, atrophic gastritis, small intestinal bacterial overgrowth Altered Gut Transit obstruction by gastric cancer or colon cancer, Achalasia, constipation, diarrhea Immune Dysregulation ulcerative colitis, Crohn’s disease Impaired Gut Blood Flow intestinal and colonic ischemia Neoplastic Degeneration Esophageal, gastric, colon, pancreatic, biliary cancer Disorders without Obvious Organic Abnormalities IBS Genetic Influences Classification of Liver Diseases Viral Hepatits Nonalcoholic fatty liver Alcoholic liver disease Immune autoimmune liver diseases Drug-induced liver disease Genetic liver diseases Mass lesions Vascular injury Liver involvement in systemic diseases ?The diagnosis drives predominantly from the patient’s history ?The physician must identify the timing, type,location and severity of the symptoms, when and where they occur, aggravating and alleviating factors, and any associated symptoms. Cardinal Symptoms of GI diseases Abdominal pain GI and extra GI peptic ulcer,appendicitis, IBD Heartburn gastroesophageal reflux disease, GERD Nausea Vomiting Altered bowel habits constipation, diarrhea, steatorrhea GI bleeding melena/hematemesis/hematochezia Jaundice Choledocholithiasis, cholangitis, pancreas, pancreatic cancer Cardinal symptoms of liver diseases Fatigue: most common, intermittent variable Nausea vomiting: most severe liver dis.