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Esophagus
- diseases
Classification?
Most
frequent/important
ones ?
Non-neoplastic
– inflammation
course: acute/chronic  cause: viruses (CMV, HSV), bakteria –
mixed flora or TB, fungi, CHEMICAL GERD

 location: superficial/intersticial
– pseudotumours
Neoplastic
Inflammation -
Classification:
Type of exsudate:





serous
nonpurulent –
lymphoplasmocellular
purulent
fibrinous
gangrenous
Candida esophagitis
Tuberculosis
Esophagus
Pseudotumours
?
Esophagus
Pseudotumours
Diverticula
Esophageal Diverticula – saclike
bulgings of oesophageal wall
1.
2.
3.
pharyngoesophageal (Zenker´s) pulsion
diverticulum
thoracic – traction d. (paraesoph.
pathology)
epiphrenic – parahiatal diverticulum
Oesophagus
Neoplasms ?
NEOPLASIA – classification
HISTOGENETIC






mesenchymal
epithelial
neuroectodermal
mixed, teratoma
choriocarcinoma
mesotelioma
Epithelial Tumours

surface epithelium
papillomas
carcinomas / papillocarcinomas

glandular epithelium
adenomas
adenocarcinomas

double diff.
mucoepidermoid
Diseases of Stomach

inflamm.
– acute
– chronic
gastritis A (autoimmune, atrophy, risk. of int. ca
 B (Helicobacter pylori)

 pseudotumours:
trichobezoar
 tumours
– benign: adenoma (polypose) , lipoma, leiomyoma,
MALIGNANT - adenoca, lymphoma
Diseases of Stomach

inflamm.
– acute
– chronic
gastritis A (autoimmune, atrophy, risk. of int. ca
 B (Helicobacter pylori)

 pseudotumours:
trichobezoar
 tumours
– benign: adenoma (polypose) , lipoma, leiomyoma,
MALIGNANT - adenoca, lymphoma
Stomach & duodenum ulcers
etiology:
 clinic :
 complications:

Stomach & duodenum ulcers
etiol.: Helicobacer pylori, chron.
gastritis B, habitual, seasonal influence,
stress, smoking
 clin. : pain, bleeding chron. & acute,
weight loss,
 complications: exsanguination,
perforation, penetration, peritonitis,
malignancy

Diseases of the small bowel

inflammation
– acute (typhus abdominalis)
– chronic
m. Crohn (autoimmune)
 coeliakia –gluten enteropathy - malabsorption syndrome
 m. Whipple (Tropheryma Whippeli

 pseudotumours
 TUMOURS
– RARE
– benigní adenom (polypose) , lipoma, leiomyoma, carcinoid
– malignant - adenoca, lymphoma
Diseases of the small bowel
 Complications:
motility & absorption disorders
MALABSORPTION
Diseases of the large bowel
 diverticulosis
 inflamm.
– acute (dysenteria, clostridium difficile )
– chronic
 ulcerose
colitis (autoimmune)
 diverticulitis
Complications: motility disorders
 TUMOURS – VERY FREQUENT
– benign adenoma (polypose) , lipoma, leiomyoma,
carcinoid
– malignant - adenoca
Large bowel carcinoma
Czech Rep. – worldwide highest incidence Predisp.
factors: genetic, lifestyle

Symptomes:
– right half – silent for a long time Bleeding occult or manifest. Weight
loss. Passage disturbances.

Diagnosis:
– imaging, endoscopy, BIOPSY

Complications:
– stenosis or perforation, peritonitis, M
– METASTASES
Large bowel carcinoma
Czech Rep. – worldwide highest incidence
Predisp. factors: genetic, lifestyle
 Symptomes:
right half – silent for a long time
Bleeding occult or manifest. Weight loss.
Passage disturbances.
 Diagnosis:
imaging, endoscopy, BIOPSY
 Complications:
stenosis or perforation,
peritonitis, METASTASES
ILEUS -
bowel obstruction
Def.: disruption of the normal propulsive ability of the GIT
(stop of the passage )
 MECHANICAL
– obstruction (tumour, stone, parasites, foreign body …
– strangulation
 DYNAMICAL
– paralytic (peritonitis)
– spastic (inervation disturbances)

combined….
Diseases of Pancreas
 inbor
– mukoviscidosis – cystic pancreatofibrosis hemochromatosis
- MALABSORPTION
 acquired
– inflammation
acute – hemorrhagic necrosis
 chronic – in etanol abusers nodular- pseudotumour and
precancerosis

– Neoplasms
exocrine – carcinomas
 endocrine – nesidiomas (e.g. insulinoma) – classified mostly as low
grade neuroendocrine carcinomas, less frequently high grade

Mucoviscidosis
cystic fibrosis, fibrocystic disease

autosomal recessive 7th chromosome
2-5% heterozygotic carriers in the caucasian
population

abnormal viscosity of mucin
– disturbance of the membrane associated
protein that serves as a calcium channel


increased concentration of chloride in sweat
decreased water content in excocrine secrets
Mucoviscidosis
cystic fibrosis, fibrocystic disease
Complications:
–
–
–
–
meconium ileus
steatorrhea
pancreatic fibrosis & cysts
bronchitis, bronchopneumonia,
bronchiectasia
– sterility