外迷信 消化系统泛论-王吉耀[优质文档].ppt

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 disea