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Diseases of the pharynx, esophagus and stomach

Among the diseases of the pharynx and pharynx, angina, the infectious disease with the expressed inflammatory changes in the lymphadenoid tissue of the pharynx and palatine tonsils, has the greatest clinical significance. The following forms of acute angina are distinguished: catarrhal, lacunar, follicular, fibrinous, purulent, necrotic and gangrenous. In chronic tonsillitis, hyperplasia, sclerosis of the lymphoid tissue of the tonsils and capsules occur. Angina can be complicated by sepsis, cause the development of rheumatism, glomerulonephritis.

Gastritis is an inflammatory disease of the gastric mucosa that can have an acute or chronic course. Acute gastritis is catarrhal, fibrinous, purulent (phlegmonous), necrotic (corrosive). Chronic gastritis is characterized by prolonged dystrophic and necrobiotic changes in the epithelium of the mucous membrane, resulting in violations of its regeneration and structural rearrangement of the mucous membrane. Chronic gastritis, based on the characteristics of morphogenesis, is divided into superficial, with damage to the glands without atrophy, atrophic, atrophic-hypertrophic, and hypertrophic (Menetrie disease).

Peptic ulcer is a chronic cyclically occurring disease, the main clinical and morphological symptom of which is a recurrent ulcer of the stomach or duodenum. Among the pathogenetic factors of peptic ulcer, there are general (violation of the neuro-humoral regulation of the stomach and duodenal ulcer) and local (increased activity of the acid-peptic factor, violation of the mucous barrier and morphological changes in the mucous membrane of the stomach and duodenum).

Chronic gastric ulcer has an oval or round shape, raised calloused edges (callous ulcer), one of which is sap and the other is gentle. During an exacerbation, chronic ulcers are characterized by inflammatory-necrotic processes; during remission, sclerotic and regenerative changes predominate. With peptic ulcer, the following complications are distinguished: 1) bleeding; 2) perforation (perforation); 3) penetration; 4) cicatricial stenosis of the pylorus.

Currently, malignancy of chronic ulcers occurs in no more than 1% of cases.

Gastric cancer in frequency ranks second among human cancers. It occurs more often in men. According to the location of the tumor in the stomach, there are: 1) pyloric cancer; 2) cancer of small curvature; 3) cardiac; 4) large curvature; 5) fundal; 6) total.

By the nature of growth, cancer happens: 1) with predominantly exophytic expansive growth; 2) with predominantly endophytic infiltrating growth; 3) mixed exophytic.

Currently, based on morphogenesis, two main histological types of stomach cancer are distinguished: intestinal (intestinal) and diffuse.

Intestinal cancer occurs from gastric mucosa epithelial cells undergoing intestinal metaplasia.

Diffuse cancer develops from intestinal-type epithelial cells that do not undergo metaplasia.

Histological variants of gastric cancer: 1) adenocarcinoma; 2) fibrotic cancer (Skirr); 3) mucous (cricoid-cell carcinoma); 4) squamous; 5) mixed (glandular squamous, glandular solid), 6) small cell lymphocyte-like, 7) anaplastic.

Gastric cancer produces lymphogenous ortho- and retrograde (virchovskie, Schnitzler, kruckenberg), and hematogenous metastases in the liver, lungs, pancreas, adrenal glands.


Ulcerative esophagitis (okr. GE) ..

Designations: 1) inflammatory-necrotic detritus at the bottom of a peptic ulcer; 2) preserved multilayer squamous non-keratinizing epithelium; 3) peptic ulcer of the mucous membrane of the esophagus.

2. Atrophic gastritis (okr. GE).

Designations: 1) thinning of the mucous membrane; 2) small atrophic fundus glands; 3) lymphohistiocytic infiltration of the stroma.

3. An ulcer of the duodenum (okr. GE).

Designations: 1) fibrinoid necrosis in the bottom of a peptic ulcer; 2) creeping mucous membrane; 3) necrosis of the wall of a blood vessel in the area of ​​a peptic ulcer; 4) granulation tissue.

4. Adenocarcinoma of the stomach (okr. GE).

Designations: 1) normal glands of the mucous membrane; 2) atypical polymorphic glands; 3) polymorphism and hyperchromicity of cancer cells; 4) numerous mitoses in tumor cells; 5) invasive tumor growth.

5. Fibrous cancer (Skirr) of the stomach (okr. GE).

Designations: 1) foci of small, hyperchromic atypical tumor cells 2) extensive layers of coarse-fibrous connective tissue; 3) normal gastric mucosa 4) endophytic submucosal tumor growth.

Macro preparations

1. Fibrinous and ulcerative gastritis.

2. Chronic duodenal ulcer.

4. Perforated gastric ulcer.

5. Ulcerated cancer of the stomach.

6. Cancer of Kruckenberg.

7. Metastasis of stomach cancer in the liver.

8. Atrophic alcoholic gastritis.

Test questions topics

1. Angina. Etiology, pathogenesis, morphological characteristics of acute and chronic tonsillitis. Complications, outcomes.

2. Gastritis. Etiology, macro- and microscopic characteristics of acute and chronic forms of gastritis. Complications, outcomes.

3. Peptic ulcer of the stomach and duodenum. Etiopathogenesis, morphological characteristics during exacerbation and remission.

4. Complications of peptic ulcer of the stomach and duodenum.

5. Cancer of the stomach. Etiological factors, macroscopic characteristics, histological options, features of metastasis.

Situational task

The patient suffered from gastric ulcer for a long time. Suddenly there was a sharp pain in the epigastric region with radiation to the shoulder, cold sweat, pallor of the skin. On palpation, a sharp muscle tension of the anterior wall was noted.

1. What complication of peptic ulcer developed in the patient?

2. What is the microscopic characteristic of an ulcer during an exacerbation?

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Diseases of the pharynx, esophagus and stomach

  1. Foreign bodies in the mouth, pharynx, larynx, trachea, esophagus, stomach and intestines
    Foreign bodies can be sharp, damaging and obstructing (clogging) the pharynx, larynx and esophagus. In case of suffocation, an urgent tracheotomy is necessary. The dog is fixed in the dorsal position, the hair is quickly removed from the ventral surface of the anterior third of the neck, twice the skin is lubricated with a 3% alcohol solution of iodine. Through a needle inserted strictly along the midline of the ventral surface
  2. Diseases of the mouth, pharynx, esophagus
    Stomatitis (stomatitis) is an inflammation of the oral mucosa. All types of domestic animals are affected, but more often cattle and horses. By the nature of the inflammation, stomatitis is alternative, exudative and proliferative. Of the alternative ones, necrotic and ulcerative are most often found. Among the exudative, serous, catarrhal, purulent, fibrinous and, less often, hemorrhagic are distinguished
  3. Burns of the pharynx and esophagus
    Burns distinguish between thermal, chemical, electrical and radiation. Thermal burns of the oral cavity, pharynx and esophagus (often at the same time) usually occur when swallowing hot food, often liquid, sometimes when hot air, gas or steam gets into these cavities. In rare cases, only one organ is affected, which is associated with the duration of the contact of the damaging agent with the mucosa
  4. Foreign bodies in the throat and esophagus
    Sometimes not only kittens, but also excessively curious adult cats swallow foreign objects. Some of these items are so small that they easily slip through the throat and esophagus, and then safely pass the stomach and intestines, and go out naturally, while others can get stuck. Often, for example, fish bones are stuck between the teeth, or stuck in the back of the throat
    The reasons for the entry of foreign bodies into the esophagus in dogs may be the habit of playing various objects and, hasty food, accidentally swallowing toys. In cats, the cause of foreign bodies (most often these are sewing needles with or without thread) is the special structure of the villi of the tongue. When trying to free itself from a randomly captured foreign body, a cat pushes it with tongue movements
  7. Stomach disease. Gastritis. Peptic ulcer. Tumors of the stomach.
    1. In acute gastritis, gastric mucosa develops 1. enterolization 2. coagulation necrosis 3. productive inflammation 4. exudative inflammation 5. proliferation of integumentary epithelium 2. Intestinal metaplasia of the epithelium can develop in chronic gastritis 1. superficial 3. atrophic 2. productive 4 Catarrhal 3. Macroscopic characteristics of acute gastric ulcer 1. edge
    Diseases of the digestive system in the structure of morbidity and mortality are in third place after diseases of the organs of the cardiovascular system and tumors. In the domestic literature, the classification of these diseases is built according to the classical ideas about the division of the digestive system into the anterior, posterior and middle sections. The anterior digestive system includes
  9. Esophagus
    The normal esophagus is a hollow, well-stretched muscle tube extending from level VI of the cervical vertebra to level XI or XII of the thoracic vertebrae. These levels correspond to the transition of the pharynx to the esophagus and esophageal-gastric connection. In newborns, the esophagus has a length of 10-12 cm, and in adults - 23-25 ​​cm. There are three anatomical narrowing of the esophagus, which lasts for
  10. Esophagus
    The main clinical symptoms are difficulty swallowing, vomiting of undigested food, often immediately after eating it, weight loss, dehydration, and developmental delay. Cricofaringel achalasia. This is an acquired violation of the relaxation of the functional sphincter of the vestibule of the esophagus, creating a mechanical barrier to the passage of food. The etiology of the disease is not clear, but
    Diseases of the gastrointestinal tract are very diverse, numerous and include diseases of the pharynx, salivary glands, esophagus, stomach, intestines, pancreas, liver and gall bladder. However, peptic ulcer, stomach cancer, appendicitis and liver diseases are of the greatest importance in human pathology. ULCER DISEASE is a common chronic, cyclically occurring disease with frequent
  12. Diseases of the stomach and intestines
    1. Definition of gastritis: a) degenerative disease of the gastric mucosa b) inflammatory disease of the mucous membrane c) dysregenerative disease of the gastric mucosa d) infectious disease with damage to the gastric mucosa e) precancerous disease of the stomach Correct answer: b 2. The essence of morphological changes in acute gastritis : a) exudative inflammation
  13. Stomach ulcer
    Peptic ulcer is a chronic recurrent disease characterized by the development of peptic ulcer of the mucous membrane of the stomach or duodenum. The prevalence of peptic ulcer in the structure of gastroenterological pathology is from 3.6 to 14.8%. Boys and girls get sick equally often, only after 14 years the number of patients among young men is greater.
  14. Stomach diseases
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