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Pathophysiology prev

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Table

Disease	Cause	Symptoms									Diagnosis	Other findings
		Pain			Nausea & Vomiting	Heartburn	Belching or Bloating	Weight loss	Loss of Appetite	Stools	Endoscopy findings
		Location	Aggravating Factors	Alleviating Factors	Nausea & Vomiting	Heartburn	Belching or Bloating	Weight loss	Loss of Appetite	Stools	Endoscopy findings
Gastric outlet obstruction	PUD: 5% cases (most commonly affecting pylorus and initial part of the duodenum) Gastric polyps^[1]^[2] Caustic ingestion^[3] Duodenal stricture ^[4] Systemic amyloidosis of the gastrointestinal tract ^[5]^[6] Eosinophillic gastroenteritis ^[7]^[8]^[9]^[10]^[11] Obstruction by gallstones (Bouveret syndrome) Complication of acute pancreatitis: pancreatic pseudocyst formation^[12]^[13] Chronic pancreatitis ^[14]^[15] Sarcoidosis of the GIT ^[16]^[17]^[18]^[19] Bezoars^[20]^[21]^[22]^[23]^[24] Crohn's disease involving the duodenum ^[25]^[26]^[27]^[28] Gastro-duodenal tuberculosis^[29]^[30]^[31]^[32]^[33] Pyloric stenosis Ingestion of corrosives	Epigastric pain	Food
✔	✔	✔	✔	✔	Black stools in case of Peptic Ulcer Disease	Helps in the determination of site of obstruction Helps in the visualization of the gastric silhouette: Helps note the following: Gastric dilation Narrowing of the pylorus Presence of ulcers Tumors Differentiation of GOO from gastroparesis where gastric dilation is not associated with the narrowing of the pylorus	-
Acute gastritis	H. pylori NSAIDS Corticosteroids Alcohol Spicy food Viral infections Crohn's disease Autoimmune diseases Bile reflux Cocaine use Breathing machine or ventilator Ingestion of corrosives	Epigastric pain	Food	Antacids	✔	✔	✔	-	✔	Black stools	Pangastritis or antral gastritis Erosive (Superficial, deep, hemorrhagic) Nonerosive (H. pylori)	-
Chronic gastritis	H. pylori Alcohol Medications Autoimmune diseases Chronic stress	Epigastric pain	Food	Antacids	✔	✔	✔	✔	✔	-	H. pylori gastritis Atrophy Intestinal metaplasia Lymphocytic gastritis Enlarged folds Aphthoid erosions	-
Atrophic gastritis	H. pylori Autoimmune disease	Epigastric pain	-	-	✔	-		✔	✔	-	H. pylori Mucosal atrophy Autoimmune Mucosal atrophy	Iron deficiency anemia Autoimmune gastritis diagnosis include: Antiparietal and anti-IF antibodies Achlorhydria and hypergastrinemia Low serum cobalamine
Crohn's disease	Autoimmune disease	Abdominal pain	-	-	-	-	-	✔	✔	Chronic diarrhea often bloody with pus or mucus Rectal bleeding	Mucosal nodularity with cobblestoning Multiple aphthous ulcers Linier or serpiginous ulcerations Thickened antral folds Antral narrowing Hypoperistalsis Duodenal strictures	Fever Fatigue Anemia (pernicious anemia)
GERD	Lower esophageal sphincter abnormalities Hiatal hernia Abnormal esophageal contractions Prolonged emptying of stomach Gastrinomas	Epigastric pain	Spicy food Tight fitting clothing	Antacids Head elevation during sleep	✔ (Suspect delayed gastric emptying)	✔	-	-	-	-	Esophagitis Barrette esophagus Strictures	Other symptoms: Dysphagia Regurgitation Nocturnal cough Hoarseness Complications Esophagitis Strictures Barrette esophagus
Peptic ulcer disease	H. pylori Smoking Alcohol Radiation therapy Medications Zollinger-ellison syndrome	Epigastric pain sometimes extending to back Right upper quadrant pain	Duodenal ulcer Pain aggravates with empty stomach Gastric ulcer Pain aggravates with food	Antacids Duodenal ulcer Pain alleviates with food	✔	✔	-	-	-	Black stools	Gastric ulcers Discrete mucosal lesions with a punched-out smooth ulcer base with whitish fibrinoid base Most ulcers are at the junction of fundus and antrum 0.5-2.5cm Duodenal ulcers Well-demarcated break in the mucosa that may extend into the muscularis propria of the duodenum Found in the first part of duodenum <1cm	Other diagnostic tests Serum gastrin levels Secretin stimulation test Biopsy
Gastrinoma	Associated with MEN type 1	Abdominal pain	-	-	✔ (suspect gastric outlet obstruction)	✔	-	-	-	Black stools	Useful in collecting the tissue for biopsy	May present with symptoms of GERD or peptic ulcer disease Associated with MEN type 1 Diagnostic tests Serum gastrin levels Somatostatin receptor scintigraphy CT and MRI
Gastric Adenocarcinoma	H. pylori infection Smoked and salted food	Abdominal pain	-	-	✔	✔	✔	✔	✔	Black stools, or blood in stools	Esophagogastroduodenoscopy Multiple biopsies are taken to establish the diagnosis	Other symptoms Dysphagia Early satiety Frequent burping
Primary gastric lymphoma	H. pylori infection	Abdominal pain Chest pain	-	-	-	-	-	✔	-	-	Useful in collecting the tissue for biopsy	Other symptoms Painless swollen lymph nodes in neck and armpit Night sweats Fatigue Fever Cough or trouble breathing

Video codes

Normal video

Video in table

Floating video

Redirect

REDIRECTEsophageal web

synonym website

https://mq.b2i.sg/snow-owl/#!terminology/snomed/10743008

Image

Normal versus Abnormal Barium study of esophagus with varices

Image to the right

Image and text to the right

<figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline><figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline></figure-inline> Recent out break of leptospirosis is reported in Bronx, New York and found 3 cases in the months January and February, 2017.

Gallery

Histopathology of a pancreatic endocrine tumor (insulinoma). Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas^[34]
Histopathology of a pancreatic endocrine tumor (insulinoma). Chromogranin A immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas^[34]
Histopathology of a pancreatic endocrine tumor (insulinoma). Insulin immunostain. Source:https://librepathology.org/wiki/Neuroendocrine_tumour_of_the_pancreas^[34]

References

↑ Miner PB, Harri JE, McPhee MS (1982). "Intermittent gastric outlet obstruction from a pedunculated gastric polyp". Gastrointest. Endosc. 28 (3): 219–20. PMID 7129059.
↑ Gencosmanoglu R, Sen-Oran E, Kurtkaya-Yapicier O, Tozun N (2003). "Antral hyperplastic polyp causing intermittent gastric outlet obstruction: case report". BMC Gastroenterol. 3: 16. doi:10.1186/1471-230X-3-16. PMC 166166. PMID 12831404.
↑ Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK (1989). "Ingestion of corrosive acids. Spectrum of injury to upper gastrointestinal tract and natural history". Gastroenterology. 97 (3): 702–7. PMID 2753330.
↑ Taylor SM, Adams DB, Anderson MC (1991). "Duodenal stricture: a complication of chronic fibrocalcific pancreatitis". South. Med. J. 84 (3): 338–41. PMID 2000520.
↑ Menke DM, Kyle RA, Fleming CR, Wolfe JT, Kurtin PJ, Oldenburg WA (1993). "Symptomatic gastric amyloidosis in patients with primary systemic amyloidosis". Mayo Clin. Proc. 68 (8): 763–7. PMID 8331978.
↑ Friedman S, Janowitz HD (1998). "Systemic amyloidosis and the gastrointestinal tract". Gastroenterol. Clin. North Am. 27 (3): 595–614, vi. PMID 9891699.
↑ Khan S, Orenstein SR (2000). "Eosinophilic gastroenteritis masquerading as pyloric stenosis". Clin Pediatr (Phila). 39 (1): 55–7. doi:10.1177/000992280003900109. PMID 10660821.
↑ Chaudhary R, Shrivastava RK, Mukhopadhyay HG, Diwan RN, Das AK (2001). "Eosinophilic gastritis--an unusual cause of gastric outlet obstruction". Indian J Gastroenterol. 20 (3): 110. PMID 11400803.
↑ Tursi A, Rella G, Inchingolo CD, Maiorano M (2007). "Gastric outlet obstruction due to gastroduodenal eosinophilic gastroenteritis". Endoscopy. 39 Suppl 1: E184. doi:10.1055/s-2006-945125. PMID 17614041.
↑ Chen MJ, Chu CH, Lin SC, Shih SC, Wang TE (2003). "Eosinophilic gastroenteritis: clinical experience with 15 patients". World J. Gastroenterol. 9 (12): 2813–6. PMC 4612059. PMID 14669340.
↑ Lee CM, Changchien CS, Chen PC, Lin DY, Sheen IS, Wang CS, Tai DI, Sheen-Chen SM, Chen WJ, Wu CS (1993). "Eosinophilic gastroenteritis: 10 years experience". Am. J. Gastroenterol. 88 (1): 70–4. PMID 8420276.
↑ Aranha GV, Prinz RA, Greenlee HB, Freeark RJ (1984). "Gastric outlet and duodenal obstruction from inflammatory pancreatic disease". Arch Surg. 119 (7): 833–5. PMID 6732492.
↑ Agrawal NM, Gyr N, McDowell W, Font RG (1974). "Intestinal obstruction due to acute pancreatitis. Case report and review of literature". Am J Dig Dis. 19 (2): 179–85. PMID 4811173.
↑ Bradley EL (1989). "Complications of chronic pancreatitis". Surg. Clin. North Am. 69 (3): 481–97. PMID 2658160.
↑ Levenick JM, Gordon SR, Sutton JE, Suriawinata A, Gardner TB (2009). "A comprehensive, case-based review of groove pancreatitis". Pancreas. 38 (6): e169–75. doi:10.1097/MPA.0b013e3181ac73f1. PMID 19629001.
↑ Stampfl DA, Grimm IS, Barbot DJ, Rosato FE, Gordon SJ (1990). "Sarcoidosis causing duodenal obstruction. Case report and review of gastrointestinal manifestations". Dig. Dis. Sci. 35 (4): 526–32. PMID 2180656.
↑ Johnson FE, Humbert JR, Kuzela DC, Todd JK, Lilly JR (1975). "Gastric outlet obstruction due to X-linked chronic granulomatous disease". Surgery. 78 (2): 217–23. PMID 807981.
↑ Mulholland MW, Delaney JP, Simmons RL (1983). "Gastrointestinal complications of chronic granulomatous disease: surgical implications". Surgery. 94 (4): 569–75. PMID 6623357.
↑ Huang A, Abbasakoor F, Vaizey CJ (2006). "Gastrointestinal manifestations of chronic granulomatous disease". Colorectal Dis. 8 (8): 637–44. doi:10.1111/j.1463-1318.2006.01030.x. PMID 16970572.
↑ Bakken DA, Abramo TJ (1997). "Gastric lactobezoar: a rare cause of gastric outlet obstruction". Pediatr Emerg Care. 13 (4): 264–7. PMID 9291515.
↑ De Backer A, Van Nooten V, Vandenplas Y (1999). "Huge gastric trichobezoar in a 10-year-old girl: case report with emphasis on endoscopy in diagnosis and therapy". J. Pediatr. Gastroenterol. Nutr. 28 (5): 513–5. PMID 10328129.
↑ Phillips MR, Zaheer S, Drugas GT (1998). "Gastric trichobezoar: case report and literature review". Mayo Clin. Proc. 73 (7): 653–6. doi:10.1016/S0025-6196(11)64889-1. PMID 9663194.
↑ White NB, Gibbs KE, Goodwin A, Teixeira J (2003). "Gastric bezoar complicating laparoscopic adjustable gastric banding, and review of literature". Obes Surg. 13 (6): 948–50. doi:10.1381/096089203322618849. PMID 14738689.
↑ Zapata R, Castillo F, Córdova A (2006). "[Gastric food bezoar as a complication of bariatric surgery. Case report and review of the literature]". Gastroenterol Hepatol (in Spanish; Castilian). 29 (2): 77–80. PMID 16448609.
↑ Nugent FW, Roy MA (1989). "Duodenal Crohn's disease: an analysis of 89 cases". Am. J. Gastroenterol. 84 (3): 249–54. PMID 2919581.
↑ Kefalas CH (2003). "Gastroduodenal Crohn's disease". Proc (Bayl Univ Med Cent). 16 (2): 147–51. PMC 1201000. PMID 16278730.
↑ Matsui T, Hatakeyama S, Ikeda K, Yao T, Takenaka K, Sakurai T (1997). "Long-term outcome of endoscopic balloon dilation in obstructive gastroduodenal Crohn's disease". Endoscopy. 29 (7): 640–5. doi:10.1055/s-2007-1004271. PMID 9360875.
↑ Fitzgibbons TJ, Green G, Silberman H, Eliasoph J, Halls JM, Yellin AE (1980). "Management of Crohn's disease involving the duodenum, including duodenal cutaneous fistula". Arch Surg. 115 (9): 1022–8. PMID 6106466.
↑ Amarapurkar DN, Patel ND, Amarapurkar AD (2003). "Primary gastric tuberculosis--report of 5 cases". BMC Gastroenterol. 3: 6. PMC 155648. PMID 12703983.
↑ Rao YG, Pande GK, Sahni P, Chattopadhyay TK (2004). "Gastroduodenal tuberculosis management guidelines, based on a large experience and a review of the literature". Can J Surg. 47 (5): 364–8. PMC 3211943. PMID 15540690.
↑ Padussis J, Loffredo B, McAneny D (2005). "Minimally invasive management of obstructive gastroduodenal tuberculosis". Am Surg. 71 (8): 698–700. PMID 16217956.
↑ Di Placido R, Pietroletti R, Leardi S, Simi M (1996). "Primary gastroduodenal tuberculous infection presenting as pyloric outlet obstruction". Am. J. Gastroenterol. 91 (4): 807–8. PMID 8677960.
↑ Subei I, Attar B, Schmitt G, Levendoglu H (1987). "Primary gastric tuberculosis: a case report and literature review". Am. J. Gastroenterol. 82 (8): 769–72. PMID 3605037.
↑ ^34.0 ^34.1 ^34.2 Neuroendocrine tumor of the pancreas. Libre Pathology. http://librepathology.org/wiki/index.php/Neuroendocrine_tumour_of_the_pancreas

Template:WS Template:WH

REFERENCES

[pmid7129059-1] Miner PB, Harri JE, McPhee MS (1982). "Intermittent gastric outlet obstruction from a pedunculated gastric polyp". Gastrointest. Endosc. 28 (3): 219–20. PMID 7129059.

[pmid12831404-2] Gencosmanoglu R, Sen-Oran E, Kurtkaya-Yapicier O, Tozun N (2003). "Antral hyperplastic polyp causing intermittent gastric outlet obstruction: case report". BMC Gastroenterol. 3: 16. doi:10.1186/1471-230X-3-16. PMC 166166. PMID 12831404.

[pmid2753330-3] Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK (1989). "Ingestion of corrosive acids. Spectrum of injury to upper gastrointestinal tract and natural history". Gastroenterology. 97 (3): 702–7. PMID 2753330.

[pmid2000520-4] Taylor SM, Adams DB, Anderson MC (1991). "Duodenal stricture: a complication of chronic fibrocalcific pancreatitis". South. Med. J. 84 (3): 338–41. PMID 2000520.

[pmid8331978-5] Menke DM, Kyle RA, Fleming CR, Wolfe JT, Kurtin PJ, Oldenburg WA (1993). "Symptomatic gastric amyloidosis in patients with primary systemic amyloidosis". Mayo Clin. Proc. 68 (8): 763–7. PMID 8331978.

[pmid9891699-6] Friedman S, Janowitz HD (1998). "Systemic amyloidosis and the gastrointestinal tract". Gastroenterol. Clin. North Am. 27 (3): 595–614, vi. PMID 9891699.

[pmid10660821-7] Khan S, Orenstein SR (2000). "Eosinophilic gastroenteritis masquerading as pyloric stenosis". Clin Pediatr (Phila). 39 (1): 55–7. doi:10.1177/000992280003900109. PMID 10660821.

[pmid11400803-8] Chaudhary R, Shrivastava RK, Mukhopadhyay HG, Diwan RN, Das AK (2001). "Eosinophilic gastritis--an unusual cause of gastric outlet obstruction". Indian J Gastroenterol. 20 (3): 110. PMID 11400803.

[pmid17614041-9] Tursi A, Rella G, Inchingolo CD, Maiorano M (2007). "Gastric outlet obstruction due to gastroduodenal eosinophilic gastroenteritis". Endoscopy. 39 Suppl 1: E184. doi:10.1055/s-2006-945125. PMID 17614041.

[pmid14669340-10] Chen MJ, Chu CH, Lin SC, Shih SC, Wang TE (2003). "Eosinophilic gastroenteritis: clinical experience with 15 patients". World J. Gastroenterol. 9 (12): 2813–6. PMC 4612059. PMID 14669340.

[pmid8420276-11] Lee CM, Changchien CS, Chen PC, Lin DY, Sheen IS, Wang CS, Tai DI, Sheen-Chen SM, Chen WJ, Wu CS (1993). "Eosinophilic gastroenteritis: 10 years experience". Am. J. Gastroenterol. 88 (1): 70–4. PMID 8420276.

[pmid6732492-12] Aranha GV, Prinz RA, Greenlee HB, Freeark RJ (1984). "Gastric outlet and duodenal obstruction from inflammatory pancreatic disease". Arch Surg. 119 (7): 833–5. PMID 6732492.

[pmid4811173-13] Agrawal NM, Gyr N, McDowell W, Font RG (1974). "Intestinal obstruction due to acute pancreatitis. Case report and review of literature". Am J Dig Dis. 19 (2): 179–85. PMID 4811173.

[pmid2658160-14] Bradley EL (1989). "Complications of chronic pancreatitis". Surg. Clin. North Am. 69 (3): 481–97. PMID 2658160.

[pmid19629001-15] Levenick JM, Gordon SR, Sutton JE, Suriawinata A, Gardner TB (2009). "A comprehensive, case-based review of groove pancreatitis". Pancreas. 38 (6): e169–75. doi:10.1097/MPA.0b013e3181ac73f1. PMID 19629001.

[pmid2180656-16] Stampfl DA, Grimm IS, Barbot DJ, Rosato FE, Gordon SJ (1990). "Sarcoidosis causing duodenal obstruction. Case report and review of gastrointestinal manifestations". Dig. Dis. Sci. 35 (4): 526–32. PMID 2180656.

[pmid807981-17] Johnson FE, Humbert JR, Kuzela DC, Todd JK, Lilly JR (1975). "Gastric outlet obstruction due to X-linked chronic granulomatous disease". Surgery. 78 (2): 217–23. PMID 807981.

[pmid6623357-18] Mulholland MW, Delaney JP, Simmons RL (1983). "Gastrointestinal complications of chronic granulomatous disease: surgical implications". Surgery. 94 (4): 569–75. PMID 6623357.

[pmid16970572-19] Huang A, Abbasakoor F, Vaizey CJ (2006). "Gastrointestinal manifestations of chronic granulomatous disease". Colorectal Dis. 8 (8): 637–44. doi:10.1111/j.1463-1318.2006.01030.x. PMID 16970572.

[pmid9291515-20] Bakken DA, Abramo TJ (1997). "Gastric lactobezoar: a rare cause of gastric outlet obstruction". Pediatr Emerg Care. 13 (4): 264–7. PMID 9291515.

[pmid10328129-21] De Backer A, Van Nooten V, Vandenplas Y (1999). "Huge gastric trichobezoar in a 10-year-old girl: case report with emphasis on endoscopy in diagnosis and therapy". J. Pediatr. Gastroenterol. Nutr. 28 (5): 513–5. PMID 10328129.

[pmid9663194-22] Phillips MR, Zaheer S, Drugas GT (1998). "Gastric trichobezoar: case report and literature review". Mayo Clin. Proc. 73 (7): 653–6. doi:10.1016/S0025-6196(11)64889-1. PMID 9663194.

[pmid14738689-23] White NB, Gibbs KE, Goodwin A, Teixeira J (2003). "Gastric bezoar complicating laparoscopic adjustable gastric banding, and review of literature". Obes Surg. 13 (6): 948–50. doi:10.1381/096089203322618849. PMID 14738689.

[pmid16448609-24] Zapata R, Castillo F, Córdova A (2006). "[Gastric food bezoar as a complication of bariatric surgery. Case report and review of the literature]". Gastroenterol Hepatol (in Spanish; Castilian). 29 (2): 77–80. PMID 16448609.

[pmid2919581-25] Nugent FW, Roy MA (1989). "Duodenal Crohn's disease: an analysis of 89 cases". Am. J. Gastroenterol. 84 (3): 249–54. PMID 2919581.

[pmid16278730-26] Kefalas CH (2003). "Gastroduodenal Crohn's disease". Proc (Bayl Univ Med Cent). 16 (2): 147–51. PMC 1201000. PMID 16278730.

[pmid9360875-27] Matsui T, Hatakeyama S, Ikeda K, Yao T, Takenaka K, Sakurai T (1997). "Long-term outcome of endoscopic balloon dilation in obstructive gastroduodenal Crohn's disease". Endoscopy. 29 (7): 640–5. doi:10.1055/s-2007-1004271. PMID 9360875.

[pmid6106466-28] Fitzgibbons TJ, Green G, Silberman H, Eliasoph J, Halls JM, Yellin AE (1980). "Management of Crohn's disease involving the duodenum, including duodenal cutaneous fistula". Arch Surg. 115 (9): 1022–8. PMID 6106466.

[pmid12703983-29] Amarapurkar DN, Patel ND, Amarapurkar AD (2003). "Primary gastric tuberculosis--report of 5 cases". BMC Gastroenterol. 3: 6. PMC 155648. PMID 12703983.

[pmid15540690-30] Rao YG, Pande GK, Sahni P, Chattopadhyay TK (2004). "Gastroduodenal tuberculosis management guidelines, based on a large experience and a review of the literature". Can J Surg. 47 (5): 364–8. PMC 3211943. PMID 15540690.

[pmid16217956-31] Padussis J, Loffredo B, McAneny D (2005). "Minimally invasive management of obstructive gastroduodenal tuberculosis". Am Surg. 71 (8): 698–700. PMID 16217956.

[pmid8677960-32] Di Placido R, Pietroletti R, Leardi S, Simi M (1996). "Primary gastroduodenal tuberculous infection presenting as pyloric outlet obstruction". Am. J. Gastroenterol. 91 (4): 807–8. PMID 8677960.

[pmid3605037-33] Subei I, Attar B, Schmitt G, Levendoglu H (1987). "Primary gastric tuberculosis: a case report and literature review". Am. J. Gastroenterol. 82 (8): 769–72. PMID 3605037.

[aaa-34] 34.0 ^34.1 ^34.2 Neuroendocrine tumor of the pancreas. Libre Pathology. http://librepathology.org/wiki/index.php/Neuroendocrine_tumour_of_the_pancreas

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