病理学英文课件-消化系统
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【病理学课件】消化系统疾病(1)
1.主细胞 2.壁细胞 3.颈粘液细胞
第一节 胃 炎（gastritis)
胃粘膜的炎性病变 （一）急性胃炎 （二）慢性胃炎
（一）急性胃炎（acute gastritis）
类型
1. 急性刺激性胃炎（acute irritated gastritis） 2. 急性出血性胃炎（acute hemorrhagic gastritis） 3. 腐蚀性胃炎（corrosive gastritis） 4. 急性感染性胃炎（acute infective gastritis）
萎缩性胃炎伴肠上皮化生
慢性萎缩性胃炎
胃镜： 正常粘膜的橘红色变淡、消失，代之
以灰白或灰黄色； 粘膜明显变薄，皱襞变浅/消失； 粘膜下血管分支清晰可见。
慢性萎缩性胃炎
病因 部位 抗内因子、壁细胞抗体 vitＢ12水平 恶性贫血 胃酸分泌 胃内G细胞的增生 血清胃泌素水平 伴消化道溃疡
Ａ型 自身免疫 胃体、胃底 阳性
降低 常有 下降
有 高 无
Ｂ型 HP感染 胃窦 阴性
正常 无 正常或稍降 无 低 常有
慢性肥厚性胃炎
部位：胃底、体部 病变特点：粘膜肥 厚，皱襞加深变宽 似脑回状
慢性肥厚性胃炎
慢性肥厚性胃炎（Menetrier病）
慢性肥厚性胃炎
光镜： 腺体肥大增生，腺管延长
粘膜固有层炎细胞浸润不明显
疣状胃炎
消化系统疾病
Diseases of the Digestive System
消 化 系 统
消化系统疾病
胃炎 消化性溃疡 炎症性肠病 病毒性肝炎 酒精性肝病 肝硬化 消化系统常见肿瘤
Cadiac 贲门
Fundus 胃底
Corpus 胃体
第一节 胃 炎（gastritis)
胃粘膜的炎性病变 （一）急性胃炎 （二）慢性胃炎
（一）急性胃炎（acute gastritis）
类型
1. 急性刺激性胃炎（acute irritated gastritis） 2. 急性出血性胃炎（acute hemorrhagic gastritis） 3. 腐蚀性胃炎（corrosive gastritis） 4. 急性感染性胃炎（acute infective gastritis）
萎缩性胃炎伴肠上皮化生
慢性萎缩性胃炎
胃镜： 正常粘膜的橘红色变淡、消失，代之
以灰白或灰黄色； 粘膜明显变薄，皱襞变浅/消失； 粘膜下血管分支清晰可见。
慢性萎缩性胃炎
病因 部位 抗内因子、壁细胞抗体 vitＢ12水平 恶性贫血 胃酸分泌 胃内G细胞的增生 血清胃泌素水平 伴消化道溃疡
Ａ型 自身免疫 胃体、胃底 阳性
降低 常有 下降
有 高 无
Ｂ型 HP感染 胃窦 阴性
正常 无 正常或稍降 无 低 常有
慢性肥厚性胃炎
部位：胃底、体部 病变特点：粘膜肥 厚，皱襞加深变宽 似脑回状
慢性肥厚性胃炎
慢性肥厚性胃炎（Menetrier病）
慢性肥厚性胃炎
光镜： 腺体肥大增生，腺管延长
粘膜固有层炎细胞浸润不明显
疣状胃炎
消化系统疾病
Diseases of the Digestive System
消 化 系 统
消化系统疾病
胃炎 消化性溃疡 炎症性肠病 病毒性肝炎 酒精性肝病 肝硬化 消化系统常见肿瘤
Cadiac 贲门
Fundus 胃底
Corpus 胃体
《病理学》第9章 消化系统疾病 ppt课件
自身抗体：PCA(胃壁细胞微粒体抗体) IFA(壁细胞内的内因子抗体)
chronic gastritis
慢性浅表性胃炎
chronic superficial gastritis
肉眼观察：黏膜充血，浅表糜烂 镜下变化：病变位于黏膜浅层，淋巴 细胞、浆细胞浸润，粘膜充血、水肿。
chronic gastritis
chronic gastritis
chronic gastritis
慢性萎缩性胃炎，AB/PAS 染色：
胃腺上皮--紫红色
肠上皮化生--蓝色
Chronic atrophic gastritis is associated with autoantibodies that block or bind intrinsic factor. Another type of autoantibody demonstrated here is anti-parietal cell antibody.
慢性溃疡性结肠炎
chronic ulcerative colitis
病因不明的慢性复发性肠道炎症性疾病。 遗传倾向、肠粘膜结构异常、感染、 免疫反应异常和精神神经因素等可能在发 病中起作用。
局限性肠炎
regional enteritis
又称Crohn病。 临床：主要表现为腹泻、腹痛、部分性肠
梗阻、腹部包块等症状。
regional enteritis
肉眼：回肠末段最常受累，但消化道的其他部位 及消化道外器官(如关节)均可累及。 病变呈节段性分布，病变肠段与正常肠段 分界清楚。 肠壁全层炎受累肠壁明显增厚，肠腔狭窄。 溃疡形成裂隙状溃疡。 卵石症溃疡间肠粘膜水肿隆起，而呈铺路石样外观。
食管与胃交界齿状线数厘米以上黏膜出现单 层柱状上皮化生
chronic gastritis
慢性浅表性胃炎
chronic superficial gastritis
肉眼观察：黏膜充血，浅表糜烂 镜下变化：病变位于黏膜浅层，淋巴 细胞、浆细胞浸润，粘膜充血、水肿。
chronic gastritis
chronic gastritis
chronic gastritis
慢性萎缩性胃炎，AB/PAS 染色：
胃腺上皮--紫红色
肠上皮化生--蓝色
Chronic atrophic gastritis is associated with autoantibodies that block or bind intrinsic factor. Another type of autoantibody demonstrated here is anti-parietal cell antibody.
慢性溃疡性结肠炎
chronic ulcerative colitis
病因不明的慢性复发性肠道炎症性疾病。 遗传倾向、肠粘膜结构异常、感染、 免疫反应异常和精神神经因素等可能在发 病中起作用。
局限性肠炎
regional enteritis
又称Crohn病。 临床：主要表现为腹泻、腹痛、部分性肠
梗阻、腹部包块等症状。
regional enteritis
肉眼：回肠末段最常受累，但消化道的其他部位 及消化道外器官(如关节)均可累及。 病变呈节段性分布，病变肠段与正常肠段 分界清楚。 肠壁全层炎受累肠壁明显增厚，肠腔狭窄。 溃疡形成裂隙状溃疡。 卵石症溃疡间肠粘膜水肿隆起，而呈铺路石样外观。
食管与胃交界齿状线数厘米以上黏膜出现单 层柱状上皮化生
病理学课件消化
精品PPT
进 展 期 胃 癌 〔 中、晚期胃癌 〕： 癌 组 织 浸 润 超 过 粘 膜 下 层 ，达 肌 层 或 浆膜,常有扩散或转移。
大体类型： 1 . 息 肉 型 ：蕈状、菜花状、息肉状 〔 充盈缺损 〕 2 . 溃 疡 型 ：〔 龛影 〕
3 . 浸 润 型 ：革囊胃
4 . 胶 样 癌 ：粘液样外观
精品PPT
临床病理联系 早期胃癌： 无明显病症。
胃癌
进展期胃癌：食欲不振、消化不良； 持续性胃痛； 出血、贫血、呕血、黑便； 幽门梗阻。
晚期出现恶病质、肿瘤转移的病症及体 征。
精品PPT
肝胆疾病
一、病毒性肝炎
一、概述：1、定义：由肝炎病毒引起的以肝实质 细胞变性、坏死为主的传染病。
2、发病无性别及年龄限制。 二、病因及发病机制：
精品PPT
胃癌 胃癌〔carcinoma of stomach 〕是由胃粘膜上 皮和腺上皮发生的恶性肿瘤。居我国消化道恶性肿 瘤首位。好发年龄为40 ~ 60岁，男性多于女性。 病因： 1、化学致癌物质：黄曲霉毒素、亚硝酸盐等。 2、 HP感染 3、微量元素和维生素缺乏：维生素 C 缺乏。 4、癌前病变：慢性萎缩性胃炎、胃息肉、慢性
粘膜屏障：脂蛋白、可防止H=逆向弥散。 回忆：胃屏障
粘液—Hco5 -屏障：壁细胞 Hcl， 可中和胃酸, 减少对粘膜的损害。
精品PPT
主要因素：①防御屏障被破坏： Asprin、阿司匹林、酒精、胆酸、胰液
H+逆向弥散至粘膜层 损伤Cap 的内皮细胞 出血 血浆蛋白渗出
肥大细胞 组织胺
微血管扩张，通透性
精品PPT
二、急性胃炎：依据病因不同分为以下四类
名称
病因
病理变化
进 展 期 胃 癌 〔 中、晚期胃癌 〕： 癌 组 织 浸 润 超 过 粘 膜 下 层 ，达 肌 层 或 浆膜,常有扩散或转移。
大体类型： 1 . 息 肉 型 ：蕈状、菜花状、息肉状 〔 充盈缺损 〕 2 . 溃 疡 型 ：〔 龛影 〕
3 . 浸 润 型 ：革囊胃
4 . 胶 样 癌 ：粘液样外观
精品PPT
临床病理联系 早期胃癌： 无明显病症。
胃癌
进展期胃癌：食欲不振、消化不良； 持续性胃痛； 出血、贫血、呕血、黑便； 幽门梗阻。
晚期出现恶病质、肿瘤转移的病症及体 征。
精品PPT
肝胆疾病
一、病毒性肝炎
一、概述：1、定义：由肝炎病毒引起的以肝实质 细胞变性、坏死为主的传染病。
2、发病无性别及年龄限制。 二、病因及发病机制：
精品PPT
胃癌 胃癌〔carcinoma of stomach 〕是由胃粘膜上 皮和腺上皮发生的恶性肿瘤。居我国消化道恶性肿 瘤首位。好发年龄为40 ~ 60岁，男性多于女性。 病因： 1、化学致癌物质：黄曲霉毒素、亚硝酸盐等。 2、 HP感染 3、微量元素和维生素缺乏：维生素 C 缺乏。 4、癌前病变：慢性萎缩性胃炎、胃息肉、慢性
粘膜屏障：脂蛋白、可防止H=逆向弥散。 回忆：胃屏障
粘液—Hco5 -屏障：壁细胞 Hcl， 可中和胃酸, 减少对粘膜的损害。
精品PPT
主要因素：①防御屏障被破坏： Asprin、阿司匹林、酒精、胆酸、胰液
H+逆向弥散至粘膜层 损伤Cap 的内皮细胞 出血 血浆蛋白渗出
肥大细胞 组织胺
微血管扩张，通透性
精品PPT
二、急性胃炎：依据病因不同分为以下四类
名称
病因
病理变化
消化系统(英文版) PPT课件
The liver, gallbladder, and pancreas are accessory organs of the digestive system that are closely associated with the small intestine.
The large intestine is made up of three portions: the ascending, transverse and descending colon. It is the portion of the digestive system most responsible for absorption of water from the indigestible residue of food. The ileocecal valve of the ileum (small intestine) passes material into the large intestine at the cecum. Material passes through the ascending, transverse, descending and sigmoid portions of the colon, and finally into the rectum. From the rectum and anus, the waste is expelled from the body.
Liver is the largest gland in the body. On the surface, the liver is divided into two major lobes and two smaller lobes. It overlies and almost completely covers the stomach.
The large intestine is made up of three portions: the ascending, transverse and descending colon. It is the portion of the digestive system most responsible for absorption of water from the indigestible residue of food. The ileocecal valve of the ileum (small intestine) passes material into the large intestine at the cecum. Material passes through the ascending, transverse, descending and sigmoid portions of the colon, and finally into the rectum. From the rectum and anus, the waste is expelled from the body.
Liver is the largest gland in the body. On the surface, the liver is divided into two major lobes and two smaller lobes. It overlies and almost completely covers the stomach.
双语医学课件-消化系统TheDigestive
胃溃疡
病因
胃酸和蛋白酶的消化是形成胃溃 疡的主要因素，长期不良饮食习 惯、精神压力大、药物刺激等也
可能导致胃溃疡。
症状
上腹疼痛、饱胀、反酸、嗳气等 是胃溃疡的常见症状，严重时可
出现出血、穿孔等并发症。
治疗
药物治疗是胃溃疡的主要治疗方 法，同时需要改善饮食习惯和生
活方式。
肠道疾病
肠易激综合征
一种功能性肠病，表现为 腹痛、腹胀、排便习惯改 变等症状，但无器质性病 变。
胃
通过胃酸和消化酶进一步分解 食物，并与消化液混合形成食 糜。
大肠
包括盲肠、结肠和直肠，主要 负责吸收水分和形成粪便。
消化系统的生理作用
01
02
03
分泌消化液
口腔、胃和小肠等器官分 泌消化液，如唾液、胃酸、 胆汁和胰液，以帮助分解 食物。
蠕动运动
消化道的肌肉通过蠕动运 动推动食物向下移动，促 进食物的消化和吸收。
调节消化
神经系统和激素对消化系 统进行调节，控制消化液 的分泌、胃肠的蠕动以及 吸收过程。
02
消化系统的结构
口腔
口腔是消化系统的起始部分，主 要功能是咀嚼食物，为后续的消
化做准备。
口腔内有牙齿、舌、唾液腺等结 构，共同完成咀嚼和吞咽的动作。
口腔还是呼吸系统的入口，具有 感受味道的功能。
食管
食管是连接口腔和胃 的管道，主要功能是 输送食物进入胃。
避免久坐
长时间久坐会影响肠道蠕动，增加消化系统疾病的风险，应尽量避免 长时间保持同一姿势。
运动前的热身和运动后的放松
进行适当的热身和放松活动，有助于预防运动损伤和促进身体恢复。
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【病理学】消化系统疾病1PPT
– 粘膜薄而平滑，皱襞变平或消失，表 面呈细颗粒状；
– 粘膜灰色或灰绿色； – 粘膜下血管清晰可见。
gastroscopy examination
• （5） 光镜下：
– 固有层内有不同程度 的淋巴细胞和浆细胞 浸润
– 固有腺体萎缩，腺体 变小并有囊性扩张， 腺体数量减少或消失。
– 上皮化生：假幽门腺 化生和肠上皮化生。
定义：
• 1. 假幽门腺化生： • 胃体和胃底部正常腺体--胃底腺由类 似幽门腺的粘液分泌细胞代替。
• Pyloric gland metaplasia: the glands of the body are replaced by mucin-secreting cells resembling those of pyloric glands;
• 3. 常见溃疡：十二指肠溃疡、胃溃疡。 • 4. 复合性溃疡、多发性溃疡
（二） 病因及发病机制
1. 胃粘膜的防御屏障
• （1） 上皮分泌粘液、碳酸氢盐 • （2） 胃酸和胃蛋白酶的分泌方式 喷射
状 • （3） 粘膜表面上皮的再生能力 • （4） 健全的粘膜血液循环
2. 致病因素
• （1） 无酸无溃疡。 • （2） HP感染。 • （3） 其他因素 药物、吸烟、长期神经
Hemorrhagic perforation (rare)
Healing
Association with H.pylori
Chronic Peptic Ulcer
Hyperacidity, decreased mucosal resistance Pyloric antrum, lesser curvature; first part of duodenum 1-5 cm; may be larger; deep; flat margins One or two
– 粘膜灰色或灰绿色； – 粘膜下血管清晰可见。
gastroscopy examination
• （5） 光镜下：
– 固有层内有不同程度 的淋巴细胞和浆细胞 浸润
– 固有腺体萎缩，腺体 变小并有囊性扩张， 腺体数量减少或消失。
– 上皮化生：假幽门腺 化生和肠上皮化生。
定义：
• 1. 假幽门腺化生： • 胃体和胃底部正常腺体--胃底腺由类 似幽门腺的粘液分泌细胞代替。
• Pyloric gland metaplasia: the glands of the body are replaced by mucin-secreting cells resembling those of pyloric glands;
• 3. 常见溃疡：十二指肠溃疡、胃溃疡。 • 4. 复合性溃疡、多发性溃疡
（二） 病因及发病机制
1. 胃粘膜的防御屏障
• （1） 上皮分泌粘液、碳酸氢盐 • （2） 胃酸和胃蛋白酶的分泌方式 喷射
状 • （3） 粘膜表面上皮的再生能力 • （4） 健全的粘膜血液循环
2. 致病因素
• （1） 无酸无溃疡。 • （2） HP感染。 • （3） 其他因素 药物、吸烟、长期神经
Hemorrhagic perforation (rare)
Healing
Association with H.pylori
Chronic Peptic Ulcer
Hyperacidity, decreased mucosal resistance Pyloric antrum, lesser curvature; first part of duodenum 1-5 cm; may be larger; deep; flat margins One or two
消化系统的英文PPT演示课件
9
10
• The small intestine is the region of the gut where nearly all of the chemical digestion of the nutrition components of food take place.
• It divided into 3 sections:1)the duodenum 2)the jejunum 3)the ileum
8
The stomach
It is composed of an upper portion called fundus,a middle section known as the body and a lower portion, called the antrum.
The cardiac sphincter relaxes and contracts to move food from the esophagus into the stomach ,whereas the pyloric sphincter allows food to leave the stomach when it sufficiently digested.
5
6
7
• The pharynx or throat ,is a passageway for food from the mouth to the esophagus and as a passway for air from nose to the windpipe.
As the stomach fills ,the rugae unfolded, exposing the digestive glands and stimulating them to secret digestive enzymes and hydrochloric acid. These substances help transform food present to a semifluid substance.
10
• The small intestine is the region of the gut where nearly all of the chemical digestion of the nutrition components of food take place.
• It divided into 3 sections:1)the duodenum 2)the jejunum 3)the ileum
8
The stomach
It is composed of an upper portion called fundus,a middle section known as the body and a lower portion, called the antrum.
The cardiac sphincter relaxes and contracts to move food from the esophagus into the stomach ,whereas the pyloric sphincter allows food to leave the stomach when it sufficiently digested.
5
6
7
• The pharynx or throat ,is a passageway for food from the mouth to the esophagus and as a passway for air from nose to the windpipe.
As the stomach fills ,the rugae unfolded, exposing the digestive glands and stimulating them to secret digestive enzymes and hydrochloric acid. These substances help transform food present to a semifluid substance.
《病理学》消化系统疾病 ppt课件
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Gastric Ulcer
Duodenal Ulcer
ppt课件
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ppt课件
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ppt课件
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（四）结局及合并症（fate and complications）
1、愈合 healing 肉芽组织增生 -- 机化 -- 瘢痕 2、出血 hemorrhage 1/3，最多见；小血管 → 潜血、 黑便；大血管 → 呕血、失血性休克
第一节 胃炎 P278
一．急性胃炎
二. 慢性胃炎
（一）慢性浅表性胃炎 （二）慢性萎缩性胃炎
ppt课件
4
一、胃炎(gastritis) 胃粘膜的炎症性病变 常见、多 发 急性胃炎：原因较清楚，嗜中性粒细胞浸润 慢性胃 炎：自身免疫、胆汁返流、急性迁延，幽门螺杆菌
（一）急性胃炎(acute gastritis) 依据病因、胃粘膜 病变分型 gastritis）
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增殖性动脉内膜炎（管壁增厚、管腔狭窄）：妨碍组织再生不 易愈合；防止溃疡底血管出血 神经细胞、神经纤维变性、 断裂 → 球状增生（创伤性神经纤维瘤）→ 疼痛 溃疡边缘 粘膜肌层与肌层粘连→诊断溃疡病的重要依据
十二指肠溃疡：球部多见，前壁或后壁，较胃溃疡小、浅， D<1.0cm
ppt课件
23
ppt课件
24
This is the normal appearance of the gastric fundal mucosa, with short pits lined by pale columnar mucus cells leading into long glandsppwt课h件ich contain bright pink 25 parietal cells that secrete hydrochloric acid.
《消化系统英文版》课件
Gallbladder
The gallbladder stores bill produced by the liver and releases it into the duodynum in response to signals from the small intent
03
Pancream
The pancras products enzymes that aid in protein, carbohydrate,
Digestive enzymes
Breaking down food into small particles through Chewing and mixing with Saliva
Secreted by the pancras, livers, and gallbladders to aid in chemical digestion
colonial utility
Elimination of waste
03
Formation of fees
Role of colon
Waste material that cannot be absorbed through the large intention where it is further processed and water is reabsorbed
Mouth
The Mouth is the opening at the antagonist end of the digestive tract It is lined by moist, pink mucosa and contains several sense receivers that aid in taste and touch The tongue is a muscular organization that aids in chewing, swinging, and speech
The gallbladder stores bill produced by the liver and releases it into the duodynum in response to signals from the small intent
03
Pancream
The pancras products enzymes that aid in protein, carbohydrate,
Digestive enzymes
Breaking down food into small particles through Chewing and mixing with Saliva
Secreted by the pancras, livers, and gallbladders to aid in chemical digestion
colonial utility
Elimination of waste
03
Formation of fees
Role of colon
Waste material that cannot be absorbed through the large intention where it is further processed and water is reabsorbed
Mouth
The Mouth is the opening at the antagonist end of the digestive tract It is lined by moist, pink mucosa and contains several sense receivers that aid in taste and touch The tongue is a muscular organization that aids in chewing, swinging, and speech
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1. Asymptomatic
2. Epigastric pain, nausea, vomiting, hematemesis and potentiallyic gastritis
Chronic gastritis is marked principally by mucosal chronic inflammatory changes and glandular atrophy with epithelial metaplasia.
• 3. Helicobacter pylori
Classification and morphology
• 1. Chronic superficial gastritis, CSG: • (1) mucosal congestion and edema. • (2) chronic inflammatory cell infiltration
CHAPTER 10
DISEASES OF ALIMENTARY SYSTEM
• Esophagitis • Gastritis (acute, chronic ) • Peptic ulcer • Enteritis(diarrheal diseases ) • Gastrointestinal carcinoma
Barrett esophagus
• Barrett esophagus is apparent as a salmonpink, velvety mucosa between the smooth, pale pink esophageal squamous mucosa and the more lush light brown gastric mucosa.
• Microscopically, the esophageal squamous epithelium is replaced by metaplastic columnar epithelium.
图10-1 Barrett食管
食管下段黏膜（距胃贲门5厘米）鳞状上皮为柱状上皮取代（化生），间质有炎细 胞浸润。切片由浙江大学医学院附属第一医院滕晓东医师提供。
Morphology • 1. Early changes : mucosal congestion
and edema.
2. Severe changes: mucosal erosions and hemorrhage
• 3. Inflammatory infiltrate
Clinical course
Acute gastritis
• An acute mucosal inflammatory process. • Accompanied by hemorrhage and by
sloughing of the superficial mucosal epithelium (erosion). • An important cause of acute gastrointestinal bleeding.
Esophagitis
Morphology
• Three histologic features are characteristic of uncomplicated reflux esophagitis ,although only one or two may be present: (1) eosinophils, with or without neutrophils, in the epithelial layer; (2) basal zone hyperplasia; and (3) elongation of lamina propria papillae. Intraepithelial neutrophils are markers of more severe injury.
Etiology and pathogenesis
• 1. Autoimmune damage: Autoimmune damage appears to be a major causal factor in type A gastritis.
• 2. A variety of mucosal irritants tobacco, alcohol, salicylates, and reflux of biliary secretions. It may be closely correlated with type B gastritis.
Clinical Features
The dominant manifestation of reflux disease is heartburn, sometimes accompanied by regurgitation of a sour brash. Rarely, chronic symptoms are punctuated by attacks of severe chest pain mimicking a heart attack. The severity of symptoms is not closely related to the presence and degree of anatomic esophagitis. Though largely limited to adults older than age 40, reflux esophagitis is occasionally seen in infants and children. The potential consequences of severe reflux esophagitis are bleeding, development of stricture, and Barrett esophagus, with its predisposition to malignancy
2. Epigastric pain, nausea, vomiting, hematemesis and potentiallyic gastritis
Chronic gastritis is marked principally by mucosal chronic inflammatory changes and glandular atrophy with epithelial metaplasia.
• 3. Helicobacter pylori
Classification and morphology
• 1. Chronic superficial gastritis, CSG: • (1) mucosal congestion and edema. • (2) chronic inflammatory cell infiltration
CHAPTER 10
DISEASES OF ALIMENTARY SYSTEM
• Esophagitis • Gastritis (acute, chronic ) • Peptic ulcer • Enteritis(diarrheal diseases ) • Gastrointestinal carcinoma
Barrett esophagus
• Barrett esophagus is apparent as a salmonpink, velvety mucosa between the smooth, pale pink esophageal squamous mucosa and the more lush light brown gastric mucosa.
• Microscopically, the esophageal squamous epithelium is replaced by metaplastic columnar epithelium.
图10-1 Barrett食管
食管下段黏膜（距胃贲门5厘米）鳞状上皮为柱状上皮取代（化生），间质有炎细 胞浸润。切片由浙江大学医学院附属第一医院滕晓东医师提供。
Morphology • 1. Early changes : mucosal congestion
and edema.
2. Severe changes: mucosal erosions and hemorrhage
• 3. Inflammatory infiltrate
Clinical course
Acute gastritis
• An acute mucosal inflammatory process. • Accompanied by hemorrhage and by
sloughing of the superficial mucosal epithelium (erosion). • An important cause of acute gastrointestinal bleeding.
Esophagitis
Morphology
• Three histologic features are characteristic of uncomplicated reflux esophagitis ,although only one or two may be present: (1) eosinophils, with or without neutrophils, in the epithelial layer; (2) basal zone hyperplasia; and (3) elongation of lamina propria papillae. Intraepithelial neutrophils are markers of more severe injury.
Etiology and pathogenesis
• 1. Autoimmune damage: Autoimmune damage appears to be a major causal factor in type A gastritis.
• 2. A variety of mucosal irritants tobacco, alcohol, salicylates, and reflux of biliary secretions. It may be closely correlated with type B gastritis.
Clinical Features
The dominant manifestation of reflux disease is heartburn, sometimes accompanied by regurgitation of a sour brash. Rarely, chronic symptoms are punctuated by attacks of severe chest pain mimicking a heart attack. The severity of symptoms is not closely related to the presence and degree of anatomic esophagitis. Though largely limited to adults older than age 40, reflux esophagitis is occasionally seen in infants and children. The potential consequences of severe reflux esophagitis are bleeding, development of stricture, and Barrett esophagus, with its predisposition to malignancy