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Gastrointestinal and genitourinary systems
Published in Helen Butler, Neel Sharma, Tiago Villanueva, Student Success in Anatomy - SBAs and EMQs, 2022
For each of the following questions, select the most appropriate answer from the above list of options. Each option may be used once, more than once or not at all. Which intraperitoneal structure connects the right and left colic flexures?Which structure connects the liver to the lesser curvature of the stomach?Name the flat muscular bands of the large intestine.Which part of the left side of the colon is intraperitoneal?Name the pouches of viscera found on the large intestine.
Electrocoagulation
Published in John P. Papp, Endoscopie Control of Gastrointestinal Hemorrhage, 2019
The secret to therapeutic endoscopy is to get the stomach clear of blood clots. An Edlich gastric lavage tube is passed into the stomach and lavage with two or more units of saline instituted. Thereafter, the patient is sedated as necessary with intravenous diazepam. If no lesion is seen in the esophagus, the endoscope is passed along the lesser curvature of the stomach into the duodenum. If no duodenal site of bleeding is found, the endoscope is withdrawn into the stomach for delineation of the cause of bleeding. If an arterial vessel is seen actively bleeding, or if a vessel is seen, one may use one of three techniques in applying electrocoagulation. Electrocoagulation should not be attempted if torrential bleeding is present nor in esophageal varices.
Stomach Microcirculation
Published in John H. Barker, Gary L. Anderson, Michael D. Menger, Clinically Applied Microcirculation Research, 2019
The anterior and posterior walls of the stomach have a similar vascular arrangement.3,4 Branches arise at intervals of about 1 cm from the arterial arcades on the greater and lesser curvature and pass on to the surface of the stomach. The arterial branches pierce the muscle coat, where they send off a branch. After having pierced the muscle coat, the branches subdivide into smaller branches in the outer portion of the submucosa. They, by anastomosing among themselves, form the main arterioarterial anastomotic plexus or primary arcade of arteries of 34 to 58 µ in diameter.3,4 These branches give rise to smaller branches of 21 to 41 µ in diameter, which interconnect with each other and their parent vessels to form a secondary arcade.3,4 The submucous plexus is continuous over the entire anterior and posterior walls and it is much less extensive near the lesser curvature. At this location, the mucosa is supplied by end-arteries that arise directly from the left gastric artery, without communication with the submucous plexus3,5 (Figure 1). This anatomic arrangement may be important in the pathogenesis of gastric ulcer.5,6 (See Section II.B. Pathology. Peptic Ulcer in this chapter).
Food Environment Index is Inversely Associated with Gastric Cancer Incidence in the United States
Published in Nutrition and Cancer, 2023
Shenghui Wu, Yanning Liu, Martie Thompson, Adam Hege
The inclusion criteria for cases in this study were the following: individuals residing in the area captured by the 16 SEER registries and diagnosed with incident-confirmed GC. GC cases were defined using the International Classification of Diseases for Oncology, Third Edition (ICD-O-3) topography code C16.0–C16.6 and C16.8–C16.9 for primary GC; a sequence number of one primary only; diagnosis between 2000 and 2015; and not reported via autopsy or death certificate only. The counts of GC cases were stratified by age at diagnosis, sex, race, year of diagnosis, and SEER registry. Each county was associated with one SEER registry. Based on the anatomic site, GC was divided into three groups: cardia (ICD-O-3: C16.0), specified non-cardia (fundus, body, antrum, pylorus lesser curvature, and greater curvature: C16.1–C16.6), and overlapping/non-specified site (C16.8–C16.9) (28). The GC histologic types were classified as adenocarcinoma [ICD-O histology codes (8140–8384 or 8480–8490)] or non-adenocarcinoma (other ICD-O histology codes) (28, 29).
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
Biopsy specimens were fixed and paraffin-embedded, and each section was stained with hematoxylin and eosin (H&E). Atrophic gastritis and intestinal metaplasia were interpreted by an experienced gastrointestinal pathologist (PYS) who was unaware of the endoscopic scores, using the updated Sydney system. The presence of atrophy was assessed based on findings of shrinking or vanishing of the glands and fibrosis of the lamina propria. The presence of metaplasia was assessed based on findings of intestinal metaplasia or pseudo-metaplasia of the corpus. OLGA and OLGLIM staging were applied according to the OLGA and OLGIM guidelines [7,22,23]. In each of the two areas (the lesser curvature and greater curvature), overall atrophy and metaplasia score expressed the sum of the percentages of atrophy/metaplasia changes and was divided by two [22]. Atrophic gastritis was graded as no, mild (1–30%), moderate (31–60%), or severe (>60%) atrophy of the observed biopsy tissue from the antrum and corpus, respectively [22]. Intestinal metaplasia was graded as non-existent, mild (1–9), moderate (10–29), or severe metaplasia (≥30%) at each antrum and corpus biopsy level, respectively. Stages 0, 1, 2 were placed into the low-risk group whereas stages 3 and 4 were the high-risk group.
Performance of chromoendoscopy and narrow-band imaging in the diagnosis of gastric intestinal metaplasia
Published in Scandinavian Journal of Gastroenterology, 2022
Nhu Thi Hanh Vu, Duc Trong Quach, Ngoc Le Bich Dang, Quang Dinh Le, Doan Thi Nha Nguyen, Huy Minh Le, Nhan Quang Le, Toru Hiyama
The first group is the group of patients undergoing WLE alone. In the second group, WLE was first performed and later changed to NBI mode combined with chromoendoscopy. Indigo carmine dye was used for staining. All patients in both groups were obtained three mapping biopsies along the small curvature according to the updated Sydney Protocol: one from the antrum 2–3 cm proximally to the pylorus, one from the incisura angularis, and one from the lesser curvature about 4 cm proximally to the incisura angularis. In the group of patients examined with chromoendoscopy and NBI, the intended locations for mapping biopsies were marked using still endoscopic images after WLE examination. And mapping biopsies were only performed after the examination with chromoendoscopy and NBI to avoid poor observation of endoscopic lesions due to possible bleeding from the prior biopsy sites. If local lesions suspected of GIM and/or dysplasia which located outside of mapping biopsy location was detected during chromoendoscopy combined with NBI, further targeted biopsy would be taken. The time duration used for endoscopic evaluation of gastric mucosa with WLE was set at five minutes for all patients in both groups. An additional 5-min examination time was set for chromoendoscopy combined with NBI. The examination time did not include biopsy and dye spraying time. The detailed steps of patient recruitment and endoscopic examination are presented in Figure 1.