China
Africa
Explore chapters and articles related to this topic
Introduction to the clinical stations
Published in Sukhpreet Singh Dubb, Core Surgical Training Interviews, 2020
Other complications of peptic ulcer disease would include penetration of the ulcer into the surrounding adjacent structures such as the pancreas. This may occur without full perforation and therefore medical treatment is mandated, although surgery may be needed if penetration is severe. Following this perforation, the ulcer erodes through the gastric or duodenal wall with access into the peritoneal cavity. Duodenal and gastric antrum ulcers are most often associated with perforations, and require emergency surgery. Gastric outlet obstruction is usually the result of chronic pyloric stenosis, as ulcers heal with scar formation. Patients may present with nausea, vomiting and on examination a succussion splash may be present.
Functional Disorders of the Stomach and Duodenum
Published in Kevin W. Olden, Handbook of Functional Gastrointestinal Disorders, 2020
In the popular literature, the stomach is considered the “heart” of the gastrointestinal (GI) tract. Irrespective of where patients may actually have pathology, they are most likely to refer to a problem with “their stomach.” Likewise, gastroenterologists are often referred to informally as “stomach specialists.” The stomach is indeed a key organ of the GI tract, with a number of features that make it unique. First, it serves as a reservoir of ingested food. Second, it serves as a powerful crushing tool, using the high-amplitude contractions of the antrum to grind ingested food particles to less than 2 millimeters, thus creating chyme for processing in the small bowel. Third, the process of digestion begins with the stomach introducing hydrochloric acid and pepsinogen into the chyme.
The Digestive (Gastrointestinal) System and Its Disorders
Published in Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss, Understanding Medical Terms, 2020
Walter F. Stanaszek, Mary J. Stanaszek, Robert J. Holt, Steven Strauss
The stomach (see Figure 6.2) in an adult is usually up to ten inches long and six inches wide with a capacity of approximately 1.5 liters, although this varies greatly. The stomach is a single distinct cavity, but anatomists divide it into four primary areas on the basis of function and physiology. The cardiac region is nearest the esophagus and forms the entry into the stomach; the fundus is the body or large central portion; the antrum, which may be viewed as the upper part of the pylorus, is the portion where narrowing begins; and the pylorus leads out of the stomach.
Prospective audit on fasting status of elective ambulatory surgery patients, correlated to gastric ultrasound
Published in Acta Chirurgica Belgica, 2023
Thibo Degeeter, Birgit Demey, Els Van Caelenberg, Luc De Baerdemaeker, Marc Coppens
Each participant was given a questionnaire related to fasting status and patients preoperative education. Subsequently a gastric ultrasound (LOGIQ e GE Medical Systems, 5.2 MHz abdominal probe) was performed with the patient in supine and right lateral decubitus position (RLD). The cross-sectional area (CSA) of the antrum of the stomach was measured with free trace mode. Residual gastric volume was calculated as: volume (mL) = 27.0 + 14.6 × right lateral CSA − 1.28 × age (y) [11,18–21]. This formula does not apply for pregnant women and patients with a BMI >40kg/m2 [19,21]. For children (11 m ≤ 18 y) residual gastric volume was calculated as: volume (mL/kg) = 6]. For each patient, antral grade was determined with grade 0 defined as empty in both supine and RLD position, grade 1 as empty in supine but clear fluid visible in RLD and grade 2 as clear fluid visible in both positions. Grade 0 and 1 correspond with a low risk of aspiration, grade 2 is high risk for aspiration. A print-out of the gastric ultrasound picture was reviewed by the most experienced anesthetist (MC). Where possible gastric volumes were measured after induction of anesthesia after aspiration though a naso-gastric tube or gastric tube through an Laryngeal Mask LMA Supreme.
Gastric lesions in patients with autoimmune metaplastic atrophic gastritis: a retrospective study in a single center
Published in Scandinavian Journal of Gastroenterology, 2022
Haiyi Hu, Rongxue Li, Linlin Shao, Qian Zhang, Rui Xu, Shutian Zhang
In this study, we included 7 AMAG patients with H. pylori infection. Endoscopic manifestation was without current H. pylori infection appearances. Intestinal metaplasia of the antrum was present in three cases. All cases displayed ECL cell hyperplasia in the corpus without multifocal atrophic gastritis. They all had positive serum anti-parietal antibody and PG I/II ratio <1. Meanwhile, they were also coexisting with vitamin B12 or iron deficiency anemia or Hashimoto’s disease. Although the cases were with H. pylori infection, it was still critically considered to be included in this AMAG cohort. The correlation between H. pylori infection and AMAG remains controversial. H. pylori infection may trigger the onset of autoimmune gastritis owing to homology between H. pylori and the proton pump H+/K+-ATPase on parietal cells [23]. Achlorhydria in AMAG might allow urease positive bacteria other than H. pylori to colonize in the stomach, causing positive 13C-UBT results. Mean 13C-UBT value in AMAG patients was 5.4 versus 17.8 in non-AMAG patients [24]. Further cases must be studied to determine its correlation.
Endoscopic scoring system for gastric atrophy and intestinal metaplasia: correlation with OLGA and OLGIM staging: a single-center prospective pilot study in Korea
Published in Scandinavian Journal of Gastroenterology, 2022
Hee Kyong Na, Kee Don Choi, Young Soo Park, Hwa Jung Kim, Ji Yong Ahn, Jeong Hoon Lee, Kee Wook Jung, Do Hoon Kim, Ho June Song, Gin Hyug Lee, Hwoon-Yong Jung
Discrepancies between endoscopic and histologic diagnosis of gastric atrophy and intestinal metaplasia have been reported. In a study reporting discrepancies between histological and endoscopic findings for atrophic gastritis in 1330 patients, the sensitivity and specificity of atrophic gastritis in the antrum were 61.5 and 57.7%, and in the corpus were 46.8 and 76.4% [24]. As for intestinal metaplasia, they were 24.0 and 91.9% in the antrum and 24.2 and 88% in the corpus [25]. In this study, the sensitivities for the diagnosis of endoscopic intestinal metaplasia were lower than our results because their diagnosis of intestinal metaplasia was evaluated only with white light endoscopy. In a recent multicenter validation study for endoscopic grading of gastric intestinal metaplasia, endoscopic score >4 correlated with stage III and IV OLGIM with 89.4% of sensitivity, 94.6% of specificity, 79.2% of PPV, and 97.5% of NPV [12]. In the study, the authors used white light endoscopy and NBI (without magnification) and the score ranged from 0 to 10. Our result showed higher sensitivity and PPV whereas lower specificity and NPV than this European study. We assume that a scoring system with high sensitivity and PPV is more useful to screen gastric cancer in the countries with a high prevalence of gastric cancer.