6 Gastritis

8/10/2019 6 Gastritis

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GASTRITISGASTRITIS

ULCER DISEASEULCER DISEASE

ss. Prof. Datsko T.V.ss. Prof. Datsko T.V.


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rosive gastritisrosive gastritis

The typia! ase ofThe typia! ase of

erosive gastritis iserosive gastritis is

harateri"e# gross!yharateri"e# gross!y

$y %i#esprea#$y %i#esprea#petehia! he&orrhagespetehia! he&orrhages

i' a'y portio' of thei' a'y portio' of the

sto&ah or regio's ofsto&ah or regio's of

o'f!(e't &(osa! oro'f!(e't &(osa! or

s($&(osa! $!ee#i'g.s($&(osa! $!ee#i'g.


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Erosio's vary i' si"e fro& ) to *+ && aross a'#Erosio's vary i' si"e fro& ) to *+ && aross a'#appear oasio'a!!y as sharp!y p('he#,o(tappear oasio'a!!y as sharp!y p('he#,o(t

(!ers. -irosopia!!y pathy &(osa! 'erosis(!ers. -irosopia!!y pathy &(osa! 'erosise/te'#i'g to the s($&(osa is vis(a!i"e# a#0ae'te/te'#i'g to the s($&(osa is vis(a!i"e# a#0ae'tto 'or&a! &(osa. The 'eroti epithe!i(& isto 'or&a! &(osa. The 'eroti epithe!i(& iseve't(a!!y s!o(ghe# a'# #eeper erosio's a'#eve't(a!!y s!o(ghe# a'# #eeper erosio's a'#

he&orrhage &ay $e prese't. I' e/tre&e aseshe&orrhage &ay $e prese't. I' e/tre&e asespe'etrati'g (!ers are assoiate# %ith 'erosispe'etrati'g (!ers are assoiate# %ith 'erosise/te'#i'g thro(gh to the serosa. Depe'#i'g o'e/te'#i'g thro(gh to the serosa. Depe'#i'g o'the age of the proess there &ay $y &i!#the age of the proess there &ay $y &i!#

i'f!a&&atio' i'itia!!y 'e(trophi!i a'# the'i'f!a&&atio' i'itia!!y 'e(trophi!i a'# the'&o'o'(!ear. 1ea!i'g is (s(a!!y o&p!ete %ithi' a&o'o'(!ear. 1ea!i'g is (s(a!!y o&p!ete %ithi' afe% #ays.fe% #ays.


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2o'erosive gastritis2o'erosive gastritis

3hro'i gastritis43hro'i gastritis4

2o'erosive gastritis refers to hro'i2o'erosive gastritis refers to hro'i

i'f!a&&atory #iseases of the sto&ah thati'f!a&&atory #iseases of the sto&ah that

ra'ge fro& &i!# s(perfiia! i'vo!ve&e't ofra'ge fro& &i!# s(perfiia! i'vo!ve&e't of

the gastri &(osa to severe atrophy.the gastri &(osa to severe atrophy.


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I'fetio(s gastritisI'fetio(s gastritisIs a hro'i i'f!a&&atory #isease ofIs a hro'i i'f!a&&atory #isease of

the a'tr(& a'# $o#y of thethe a'tr(& a'# $o#y of thesto&ah a(ses $y 1e!io$atersto&ah a(ses $y 1e!io$aterpy!ori.py!ori.

The (rve# ro#s of 1.py!ori are fo('#The (rve# ro#s of 1.py!ori are fo('#i' the s(rfae &((s of thei' the s(rfae &((s of the

epithe!ia! e!!s a'# i' the gastriepithe!ia! e!!s a'# i' the gastrifoveo!ae. Ative gastritis feat(resfoveo!ae. Ative gastritis feat(respo!y&orpho'(!ear !e(oytes i'po!y&orpho'(!ear !e(oytes i'the 'ek g!a'#s a'# i'!a&i'athe 'ek g!a'#s a'# i'!a&i'apropria. It has $ee' !ai&e# thatpropria. It has $ee' !ai&e# that

hro'i i'fetio(s gastritis a(se#hro'i i'fetio(s gastritis a(se#$y 1. py!ori a' !ea# to gastri$y 1. py!ori a' !ea# to gastriatrophy a'# i'testi'a! &etap!asia.atrophy a'# i'testi'a! &etap!asia.I' a##itio' i'fetio' %ith 1.py!oriI' a##itio' i'fetio' %ith 1.py!orihas $ee' !i'ke# to the #eve!op&e'thas $ee' !i'ke# to the #eve!op&e't

of gastri a#e'oari'o&a.of gastri a#e'oari'o&a.

R f! t iti


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Ref!(/ gastritisRef!(/ gastritis Refers to hro'i gastri i'0(ry that res(!ts fro&Refers to hro'i gastri i'0(ry that res(!ts fro&

the ref!(/ of a!ka!i'e #(o#e'a! o'te's a'# $i!ethe ref!(/ of a!ka!i'e #(o#e'a! o'te's a'# $i!ei'to the sto&ah (s(a!!y fo!!o%i'g partia!i'to the sto&ah (s(a!!y fo!!o%i'g partia!gastreto&y. 6hereas o'spi(o(s ref!(/ gastritisgastreto&y. 6hereas o'spi(o(s ref!(/ gastritisis &ost o&&o' after s(rgery a &i!#er for& isis &ost o&&o' after s(rgery a &i!#er for& isofte' i#e'tifie# i' i'tat sto&ahs fro& patie't %ithofte' i#e'tifie# i' i'tat sto&ahs fro& patie't %ith

gastri (!er postho!eysteto&y sy'#ro&e a'#gastri (!er postho!eysteto&y sy'#ro&e a'#vario(s &otor #ist(r$a'es of the #ista! sto&ah.vario(s &otor #ist(r$a'es of the #ista! sto&ah.

The ter& gastritis as app!ie# to hro'iThe ter& gastritis as app!ie# to hro'igastro#(o#e'a! ref!(/ is so&ethi'g of agastro#(o#e'a! ref!(/ is so&ethi'g of a

&is'o&er si'e it is 'ot pri&ari!y a' i'f!a&&atory&is'o&er si'e it is 'ot pri&ari!y a' i'f!a&&atory#isor#ers. The gisto!ogi appeara'e is#isor#ers. The gisto!ogi appeara'e is#o&i'ate# $y foveo!ar hyperp!asia e#e&a#o&i'ate# $y foveo!ar hyperp!asia e#e&avaso#i!atatio' a'# o'gestio' a'# a pa(ity ofvaso#i!atatio' a'# o'gestio' a'# a pa(ity of

i'f!a&&atory e!!s.i'f!a&&atory e!!s.


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trophi gastritistrophi gastritis

This o'#itio' &ay evo!ve fro& s(perfiia! gastritis $(tThis o'#itio' &ay evo!ve fro& s(perfiia! gastritis $(t

there is 'o sharp #isti'tio' $et%ee' the&. Like s(perfiia!there is 'o sharp #isti'tio' $et%ee' the&. Like s(perfiia!gastritis ative atrophi gastritis is harateri"e# $ygastritis ative atrophi gastritis is harateri"e# $ypro&i'e't hro'i i'f!a&&atio' i' the !a&i'a propria.pro&i'e't hro'i i'f!a&&atio' i' the !a&i'a propria.1o%ever !y&phoytes a'# p!as&a e!!s e/te'# o'to the1o%ever !y&phoytes a'# p!as&a e!!s e/te'# o'to the#eepest reahes of the &(osa as far as the &(s(!aris#eepest reahes of the &(osa as far as the &(s(!aris

&(osae. 7asio'a!!y !y&phoi# e!!s are arra'ge# as&(osae. 7asio'a!!y !y&phoi# e!!s are arra'ge# asfo!!i!es a' appeara'e that has !e# to a' erro'eo(sfo!!i!es a' appeara'e that has !e# to a' erro'eo(s#iag'osis of !y&pho&a or pse(#o!y&pho&a. I'vo!ve&e't#iag'osis of !y&pho&a or pse(#o!y&pho&a. I'vo!ve&e'tof the gastri g!a'#s !ea#s to #ege'erative ha'ges i' theirof the gastri g!a'#s !ea#s to #ege'erative ha'ges i' theirepithe!ia! e!!s a'# (!ti&ate!y a o'spi(o(s re#(tio' i'epithe!ia! e!!s a'# (!ti&ate!y a o'spi(o(s re#(tio' i'

the '(&$er of g!a'#s he'e the 'a&e atrophi gastritis.the '(&$er of g!a'#s he'e the 'a&e atrophi gastritis.Eve't(a!!y the i'f!a&&atory proess &ay a$!ate !eavi'gEve't(a!!y the i'f!a&&atory proess &ay a$!ate !eavi'go'!y a thi' atrophi &(osa i' %hih ase the ter& gastrio'!y a thi' atrophi &(osa i' %hih ase the ter& gastriatrophy is app!ie#.atrophy is app!ie#.


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-e'etrier #isease-e'etrier #isease 3hyperp!asti3hyperp!astigastropathy4gastropathy4

Is a' ('o&&o' #isease ofIs a' ('o&&o' #isease ofthe sto&ah harateri"e# $ythe sto&ah harateri"e# $ye'!age# r(gae. It is ofte'e'!age# r(gae. It is ofte'ao&pa'ie# $y a severeao&pa'ie# $y a severe

!oss of p!as&a protei's!oss of p!as&a protei's3i'!(#i'g a!$(&i'4 fro& the3i'!(#i'g a!$(&i'4 fro& thea!tere# gastri &(osa.Thea!tere# gastri &(osa.Thea(se of this #isor#er isa(se of this #isor#er is('k'o%'.('k'o%'.

The fo!#s of the sto&ah areThe fo!#s of the sto&ah arei'rease# i' height a'#i'rease# i' height a'#thik'ess for&i'g athik'ess for&i'g ao'vo!(te# s(rfae si&i!ar too'vo!(te# s(rfae si&i!ar tothat of the $rai'that of the $rai'


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Pepti (!er #iseasePepti (!er #isease

Refers to $reaks i' the &(osa of theRefers to $reaks i' the &(osa of the

sto&ah a'# s&a!! i'testi'e pri'ipa!!y thesto&ah a'# s&a!! i'testi'e pri'ipa!!y the

pro/i&a! #(o#e'(& that are pro#(e# $ypro/i&a! #(o#e'(& that are pro#(e# $y

the atio' of gastri seretio's.the atio' of gastri seretio's.


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Pathoge'esisPathoge'esis

E'viro'&e'ta! fatorE'viro'&e'ta! fator

Ge'eti fatorGe'eti fator

Psyho!ogia! fatorPsyho!ogia! fator 1y#roh!ori ai#1y#roh!ori ai#

Physio!ogi fators i' #(o#e'a! (!ersPhysio!ogi fators i' #(o#e'a! (!ers

Physio!ogi fators i' gasri (!ersPhysio!ogi fators i' gasri (!ers The ro!e of 1. py!oriThe ro!e of 1. py!ori

Assoiate# #iseasesAssoiate# #iseases


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Gastri (!er. TheGastri (!er. Thesto&ah has $ee' ope'e#sto&ah has $ee' ope'e#

to revea! a sharp!yto revea! a sharp!y

#e&arate# #eep pepti#e&arate# #eep pepti

(!er o' the !esser(!er o' the !esser(rvat(re(rvat(re


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D(o#e'a! (!erD(o#e'a! (!er

A sharp!y p('he#,o(tA sharp!y p('he#,o(tpepti (!er of thepepti (!er of the

#(o#e'(& sit(ate##(o#e'(& sit(ate#

i&&e#iate!y $e!o% thei&&e#iate!y $e!o% the

py!or(s.py!or(s.


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Co&p!iatio'sCo&p!iatio's

HemorrhageHemorrhage

PerforationPerforation

Pyloric obstructionPyloric obstruction

Development of combined ulcersDevelopment of combined ulcers

Malignant transformation of a benign gastricMalignant transformation of a benign gastric

ulcerulcer


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Lo% soioeo'o&i setti'gs5Lo% soioeo'o&i setti'gs5

These situations pose an increased risk ofThese situations pose an increased risk ofgastric cancer, an observation that has beengastric cancer, an observation that has beenused to explain the high freguency of theused to explain the high freguency of thetumor among American blacks and the facttumor among American blacks and the fact

that the incidence of the disease in thatthat the incidence of the disease in thatpopulation has not declined as rapidly as itpopulation has not declined as rapidly as ithas among whites.has among whites.

Atrophic gastritis, pernicious anemia, subtotalAtrophic gastritis, pernicious anemia, subtotal

gastrectomy, and gastric adenomatous polypsgastrectomy, and gastric adenomatous polypshave been discussed earlier as factorshave been discussed earlier as factorsassociated with a high resk of stomach cancerassociated with a high resk of stomach cancer


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The &a0or types of gastri a'erThe &a0or types of gastri a'er


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I'fi!trati'g gastriI'fi!trati'g gastri

ari'o&a. The %a!! ofari'o&a. The %a!! of

the sto&ah isthe sto&ah is

thike'e# a'#thike'e# a'#i'#(rate# $y #iff(se!yi'#(rate# $y #iff(se!y

i'fi!trati'g a'eri'fi!trati'g a'er


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A(te appe'#iitisA(te appe'#iitis


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-(oe!e of the-(oe!e of the

appe'#i/. Theappe'#i/. The

appe'#i/ isappe'#i/ is

o'spi(o(s!y #i!ate#o'spi(o(s!y #i!ate#$y &(i'o(s &ateria!$y &(i'o(s &ateria!

serete# $y aserete# $y a

&(i'o(s&(i'o(s

ysta#e'o&aysta#e'o&a


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6 Gastritis

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