Gastritis & Ulcers marked.pdf MBBS 4th year

GIT pathology gastritis & ulcers

1. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

2. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

3. Acute Gastritis
(Acute hemorrhagic (erosive) gastritis)
It is the inflammation of gastric mucosa.
Erosions are a defect in the epithelium of the mucosa.
Ulcers are a defect in the mucosa with extension intothe submucosa or deeper.
Risk Factors
●Nonsteroidal antiinflammatory drugs(NSAIDs)
●Alcohol
●Helicobacter pylori
●CMV
●smoking
●Burns (called Curling ulcers)
●CNS injury (called Cushing ulcers)
●Raw fish
●Chemotherapy
ICU patients have a high incidence of gastric stressulcer. These ulcers may be complicated by bleeding.
Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

4. Cause:
Due to imbalance between mucosal defenses and acidicenvironment
Clinical Findings
• Presents with abdominal pain, nausea, vomiting .
• Bleeding (hematemesis) is the most serious complication
Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

5. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

6. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

7. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

8. MORPHOLOGY :
MORPHOLOGIC FEATURES
Grossly:
●Mild acute gastritis: No significant changes
●Moderate :the gastric mucosa is oedematous with abundantmucus
●Severe gastritis: Severe mucosal damage, erosionsand hemorrhage termed acute erosive
hemorrhagic gastritis.
Microscopy:It shows, dense infiltration by neutrophilswithin the mucosa and purulent exudate in the
lumen.
Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

9. Chronic Gastritis
Divided into two types based on etiology:
●chronic autoimmune gastritis
●chronic H pylori gastritis
Autoimmune gastritisis due to autoimmune destructionof gastric parietal
cells, which are located in the stomach body and fundus.
Antibodies against parietal cells and/or intrinsicfactor.
Features :
i. Atrophy of mucosa with intestinal metaplasia
ii. Achlorhydria with increased gastrin levels andantral G-cell hyperplasia
iii. Megaloblastic (pernicious} anemia due to lackof intrinsic factor
iv. Increased risk for gastric adenocarcinoma (intestinaltype)
Chronic H pylori gastritis:is due to H pylori-inducedacute and chronic
inflammation; most common form of gastritis.
Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

10. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

11. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

12. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

13. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

14. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

15. Peptic Ulcer Disease
Ulcers o f the distal stomach and proximal duodenum
Etiology
Decreased mucosal barrier
• H. pylori
• NSAIDS (inhibiting prostaglandin production)
• Steroids
Increased acid production (duodenal ulcer only)
• Idiopathic
• Gastrin-secreting tumors (MEN 1/Zollinger-ELLisonsyndrome)
Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

16. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

17. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

18. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

19. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

20. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

21. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

22. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

23. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

24. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

25. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

26. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

27. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

28. MORPHOLOGY
Shape
Small ( < 3 cm) and round or oval
Sharply demarcated-"punched out"
Overhanging margins and radiating mucosal folds
M/E
Gastric and duodenal ulcers are microscopically similar.From the lumen outward four layers can be identified:
Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

29. Necrotic zone: It is the most superficial zone.
Superficial exudative zone: It consists of fibrinopurulentexudates with predominantly neutrophilic inflammatoryinfiltrate.
Granulation tissue zone: It consists of granulationtissue infiltrated with mononuclear leukocytes.
Zone of cicatrization: It consists of fibrous tissueor col- lagenous scar which forms the base of theulcer and may show
chronic inflammatory cells.
Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

30. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

31. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

32. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

33. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions

34. Online Pathology Session BY M. AHMAD MSA
Whatsapp at 0336-4422442 for Joining Online Sessions