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Diseasesof
theGastrointestinalTract消化系统疾病1
ThedigestivesystemThegastrointestinaltractTheliverandthebiliarytractThepancreas2
DiseasesoftheGITractEsophagusStomachSmallandlargeintestinesAppendixBarrettesophagusPepticulcerIBDEsophagealCaGastricCaColorectalCaAnatomic/Development/motorDisordersInflammatoryDiseasesEsophagitisGastritisEnterocolitisAppendicitisTumorsAdenomaReflux~Chronic~Carciod(NETs)3
Normalanatomyandhistologyoftheesophagus4
NormalanatomyandhistologyoftheesophagusLengthMucosaSubmucosa:glandsMuscularisepropriaAdventitiaG-Ejunction≠S-Cjunction5
Esophagogastricjunction≠Squamous-Columnarjunction6
EsophagitisInflammationoftheesophagealmucosaCausedbyavarietyofagentsPhysicalChemicalBiologicRefluxofgastriccontentsisthemostimportantcauseofesophagitis(refluxesophagitis)7
Refluxesophagitis(返流性食管炎)ElongationofthelaminapropriapapillaeExtendingintothetopthirdoftheepitheliumBasalcellhyperplasia1/5oftheepithelialthicknessIntraepithelialinflammatorycellsEosinophils,neutrophilsandlymphocytes8
9
Refluxesophagitis
ClinicalfeaturesAgeOver40yOccasionallyseenininfantsandchildrenThedominantmanifestationHeartburn(烧心)Regurgitationofasourbrash(返酸)ThepotentialconsequencesBleeding,ulceration,strictureAtendencytodevelopBarrettesophagus10
Barrettesophagus(巴雷特食管)DefinintionAcomplicationoflong-standinggastroesophagealrefluxThemostimportantriskfactorforesophagealadenocarcinoma在慢性反流性食管炎时，食管下段粘膜的鳞状上皮被含有杯状细胞的肠道化生上皮所取代。11
DiagnosticcriteriaEndoscopicevidenceofcolumnarepithelialliningabovethegastroesophagealjunctionHistologicevidenceofintestinalmetaplasiainthebiopsyspecimensfromthecolumnarepithelium.12
CarcinomasoftheesophagusWorldwide,squamouscellcarcinomasconstitute90%ofesophagealcancersMainlyinnorthChinaandMiddleEastAsiaAccountfor20%ofcancerdeathsButinmosto
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