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HELICOBACTER PYLORI H. pylori is involved in the aetiology of a number of common gastroduodenal diseases, such as chronic gastritis, peptic ulceration and gastric cancer. Although Bizzozero identified the presence of spirochaetal organisms in gastric mucosa, ...

Helicobacter pylori gastritis H. pylori gastritis, previously described as type B gastritis, a ff ects the antrum and predisposes to peptic ulcer disease. Helicobacter -associated pangastritis is common, but gastritis a ff ecting the corpus alone is not. Chronic...

Histopathology Microscopically , the base of the ulcer is covered with granula tion tissue and there may be evidence of endarteritis obliterans. The pathological appearances of the healing ulcer must be carefully interpreted as some of the epithelial down ...

INVESTIGATION OF THE STOMACH AND DUODENUM

Incidence There are marked variations in the incidence of gastric cancer worldwide. In the UK, it is approximately 15 per 100 /uni00A0 000 per year; in the USA, 10 per 100 /uni00A0 000 per year; and in Eastern Europe, 40 per 100 /uni00A0 000 per year. In Japa...

INTRODUCTION The stomach acts as a reservoir for ingested food, where it is mechanically broken down and the process of digestion begins before the ingested content passes into the duodenum.

Investigation of the patient with

Laparoscopy Laparoscopy is routine in the assessment of patients with gastric cancer. Its particular value is in the detection of peri - toneal disease, which is di ffi cult by any other technique, unless the patient has ascites or bulky intraperitoneal deposit...

Learning objectives To understand: The gross and microscopic anatomy and pathophysiology • of the stomach and duodenum The critical importance of gastritis and Helicobacter pylori • in upper gastrointestinal disease The causes of duodenal obstruction and the p...

Long-term complications of surgery There is very little functional di ff erence between patients who have a total gastrectomy and those who have a subtotal gastrectomy . Patients need to be given detailed nutritional advice, the substance of which is to eat sm...

Lymphatic drainage of the stomach Understanding the lymphatic drainage of the stomach is the key to understanding radical surgery for gastric cancer. The lymphatics of the antrum drain into the right gastric lymph node superiorly and right gastroepiploic and...

Lymphatics The lymphatics of the stomach are of considerable importance in surgery for gastric cancer and are described in detail in that section. - - Splenic artery Vasa brevia Left gastric artery Hepatic artery Right gastric artery Duodenal cap Gastroduode...

Lymphocytic gastritis This type of gastritis is rare. It is characterised by the infiltration of the gastric mucosa by T cells and is probably associated with H. pylori infection. The pattern of inflammation resembles that seen in coeliac disease or lymphocyt...

MICROSCOPIC ANATOMY OF THE STOMACH AND DUODENUM The gastric surface epithelial cells are mucus producing. Mucus-secreting glands are found also in the duodenum. The specialised cells of the stomach (parietal and chief cells) are found in the gastric crypts (...

Malignancy in gastric ulcers In contrast to chronic duodenal ulcers, gastric ulcers are associated with malignancy . There are two clinical scenarios that should be distinguished: one in which a benign chronic gastric ulcer undergoes malignant transformation (...

Mallory–Weiss tear This is a longitudinal tear at the GOJ, which is induced by repetitive and strenuous vomiting. Doubtless, many such lesions occur and do not cause bleeding. When it is a cause of haematemesis, the lesion may often be missed as it can be di ...

Management Treating the patient involves correcting the metabolic abnormalities and dealing with the mechanical obstruction. The patient should be rehydrated with intravenous isotonic saline with potassium supplementation. Replacing the sodium chloride and wat...

Metabolic effects V omiting hydrochloric acid results in hypochloraemic alkalosis. Initially the sodium and potassium may be relatively normal; however, as dehydration progresses, more profound metabolic abnormalities arise, partly related to renal dysfunction...