Endoscopic tour of GIT

LECTURE 2/ SEESION1

UNIVERSITY OF BABYLON
HAMMURABI MEDICAL
COLLEGE

GASTROINTESTINAL TRACT

S4-PHASE 1
2018-2019

AIMS

1. Common disease affecting
each part of GIT
2. Inttroduce structural disruption seen in some common
disorders and diseases.



DISORDERS OF THE OESOPHAGUS

DYSPHAGIA

it is difficultly swallowing.

may be caused by problems with the oesophagus, e.g. musculature,
obstruction by tumour or neurological, e.g. a stroke.

tumours of the oesophagus:

· high up are squamous cell carcinoma,

· lower down are adenocarcinomas.


Acid Reflux – Sphincter between the oesophagus and the
stomach is weak, acid refluxes into the oesophagus and causes
irritation and pain (heartburn).
Chronic oesophagitis (reflux of acidic gastric content – reflux
oesophagitis).

Barrett’s oesophagus.
It is a condition in which an abnormal columnar epithelium replaces the
stratified squamous epithelium that normally lines the distal esophagus,
results from prolonged reflux due to incompetent lower oesophageal
sphincter
it is a premalignant condition.


ENDOSCOPIC TOUR IMAGE



NORMAL ESOPHAGUS BARRET’S ESOPHAGUS


OESOPHAGEAL VARICES

Portal venous system is overloaded
due to cirrhosis, blood is diverted to the
oesophagus through connecting
vessels. This leads to the dilation of
sub mucosal veins in the lower part of
the oesophagus

Common disorders of the stomach

Gastritis (inflammation of gastric tissue) damage or erosion of mucosa

ulceration – persistent erosion;

ulcers may haemorrhage,

perforate or heal by fibrosis ,

may develop to malignant.


ENDOSCOPY TOUR OF STOMACH




NORMAL PYLORUS GASTRIC ULCER


COMMON DISORDERS OF THE INTESTINES
Duodenal ulcers due to acid chyme unprotective mucosa

DUODENUM -NORMAL DUODENAL ULCER


COELIAC DISEASE
Mucosal villi damage; leads to malabsorption > diarrohea

JAUNDICE
The liver excretes bilirubin, a breakdown product of haemoglobin. If the liver cannot excrete
bilirubin then this will accumulate in the blood .condition called Jaundice
If build up of bilirubin is due to excess haemoglobin breakdown it is pre-hepatic
jaundice. If build up of bilirubin is due to bile duct obstruction and back up of bile
causing liver damage it is post-hepatic or obstructive jaundice

Gallstones Precipitation of bile acids and cholesterol in the bladder forms
gall stones. Often asymptomatic, but may move within the gall bladder
causing painful biliary colic, or move to obstruct biliary outflow.
Tumours of the pancreas may also obstruct outflow.

Malabsorption – Several conditions affect how well the intestines can
absorb things.

Pancreatitis – inflamed pancreas, causes considerable
pain. Characterised by the release of amylases into the
blood stream

Appendicitis

Inflammation of the appendix,
presents as a sharp pain in the
side at the same level as T10,
which localises to
the right lower Quadrant


PERITONITIS
Inflammation of the peritoneum

PARALYTIC ILEUS

Occur due to motility of the ileum may be compromised under
some circumstances, may also become obstructed either from an
internal obstruction or external compression.

INFLAMMATORY BOWEL
DISEASE


CROHN’S DISEASE
Inflammatory condition affecting
small & large intestine in patches
; affects areas with high lymphoid
tissue(e.G. Terminal ileum) ,effect
full thickness of the wall

ULCERATIVE COLITIS Affects
only the large bowel mucosa ,not effect full thickness of wall


MECKELS’ DIVERTICULUM
A pouch in the lower part of the small intestine.
It can produce ectopic gastric mucosa that may then produce gastric acid,
causing irritation.


DIVERTICULAR DISEASE
Outpouching of the mucosa due to pressure is too high in the
colon in the descending & sigmoid colon


Acute blockage of small
intestines
Present with pain (in their back),
vomiting and bloating.

HAEMORRHOIDS
Vascular structures in the anal
canal that aid with stool control.
When they become swollen and
inflamed they are painful, itchy
and blood may be present in stool.


Prolapse Means ‘to fall out of place’. Prolapse is
A condition where organs fall down or slip out of place. E.G.
The rectum can prolapse



Colo-Rectal Cancer
The large intestine is a common site of malignancies, and
colo-rectal cancer is a major cause of mortality