消化系统疾病3课件.ppt

Diseases of Digestive system消化系统疾病 非肿瘤性疾病 食管炎 胃炎：慢性胃炎 消化性溃疡 阑尾炎 非特异性肠炎 肝脏疾病：病毒性肝炎， 肝硬化 胆道疾病：胆囊炎， 胆石症 胰腺疾病：胰腺炎 肿瘤性疾病 食管癌 胃癌 结直肠癌（大肠癌） 原发性肝癌 胰腺癌 Replacement of the esophageal normal distal stratified squamous mucosa by metaplastic columnar epithelium containing goblet cells. It is a complication of long-standing gastroesophageal reflux Stomach-normal histology Parietal cells: in fundus and body, make HCl (hydrochloric acid) Chief cells: in fundus and body, make pepsinogen Mucous cells: all over, make mucus G cells: in antrum, produce gastrin Ⅰ Gastritis Inflammation of the gastric mucosa, the majority of which are chronic gastritis but some distinct forms of acute gastritis are sometimes encountered This diagnosis is often both overused and missed. Chronic Gastritis Defined as the presence of chronic mucosal inflammatory changes leading eventually to mucosal atrophy and epithelial metaplasia Often asymptomatic, but probably present in over 50% of older adults Chronic Gastritis Etiologies Helicobacter pylori, H. pylori Bile reflux Others, including smoking, alcohol, radiation, uremia Autoimmune reaction Chronic superficial gastritis Chronic superficial gastritis Grossly: (on gastroscopy examination) frequently affects the antrum Congestion and edema in mucosa, deep red colour. Erosive and hemorrhagic in the superficial layer. Histologically: infiltration of lymphocytes and plasma cells within the upper third of the gastric mucosa. Lamina propria mucosa gland is normal. Tiny foci hemorrhagic erosions may appear. Chronic Atrophic Gastritis Chronic Gastritis-Pathology Gross: The mucosal folds are flattened, and mucosa layer become thin and grey-white. So submucosal vessels can be seen through the thinned mucosa Chronic Gastritis-Pathology Histology Infiltration of lymphocytes and plasma cells all over the gastric mucosa, accompanied by gathering lymphocytes Mucosal