3.The-Stomach - The Stomach The normal gastric mucosa...

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The Stomach
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The normal gastric mucosa Cardia – mainly mucus-secreting cells Fundus (body) – acid producing parietal cells, pepsin producing chief cells Pylorus – hormone (gastrin) production
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Function of stomach Mixing of food with acid/pepsin Unique acid environment requires functional gastric surface mucus barrier, bicarbonate buffering and epithelial integrity
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Congenital disorders Hiatus hernia Diaphragmatic hernia (through a non- physiological defect) Congenital pyloric stenosis. Male infants with hypertrophy of pyloric smooth muscle leading to projectile vomiting
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Gastritis Acute gastritis often due to chemical injury (alcohol drugs) Chronic gastritis: Helicobacter pylori infection Chemical damage (bile reflux, drugs) Autoimmune (associated with vitamin B12 malabsorption (pernicious anaemia)
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Acute gastritis Drugs (non-steroidal anti-inflammatory drugs NSAID), alcohol cause acute erosion (loss of mucosa superficial to muscularis mucosae). Can result in severe haemorrhage Acute Helicobacter infection has a prominent neutrophil infiltrate
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Chronic gastritis ABC A – autoimmune B – bacterial ( helicobacter ) C - chemical
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Autoimmune chronic gastritis Autoantibodies to gastric parietal cells Hypochlorhydria/achlorhydria Loss of gastric intrinsic factor leads to malabsorption of vitamin B12 with macrocytic,megaloblastic anaemia
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Morphology of chronic gastritis Chronic inflammatory cell infiltration Mucosal atrophy Intestinal (goblet cell) metaplasia Seen in Helicobacter and autoimmune gastritis (not chemical)
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Adapted to live in association with surface epithelium beneath mucus barrier
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3.The-Stomach - The Stomach The normal gastric mucosa...

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