Ulcers of the Stomach Image 1Double Pylorus With UlcersThis image shows what can happen when an ulcer injures the stomach. On the left is the normalpylorus which is the channel through which food and liquid exit the stomach into the duodenum, thefirst portion of the small bowel. On the right is a second exit which has been caused by a previousulcer which burst through into the duodenum. If it had perforated into the abdomen, it would havecaused acute peritonitis, a surgical emergency. You can see that the ulcer disease is still active witha new white-based ulcer in the distance. The previous and present ulcers were caused by thestomach bacteria infection called Helicobacter pylori. Antibiotics cleared the infection and cured herulcer problem.Malignant Tumors of the Stomach Image 1Gastric LymphomaA lymphoma is a malignant tumor that arises from the lymphoid cells in the body. They can occuralmost anywhere in the body, including the stomach. In this instance, the tumor is present in theupper portion of the stomach and appears as an irregular ball. The black endoscope can be seenbeside it. The endoscope has been bent into a U-turn so that the tumor can be seen. These tumorsusually require surgery and the outcome is often good.
Gastroesophageal Reflux Disease (GERD) Image 1 Image 2 Image 3 Image 4Examples of GERDWhen acid from the stomach bathes the lower esophagus, a feeling of heartburn occurs. In somepeople, actual tissue damage occurs. This can cause some mild inflammation or reddening of thelower esophagus as seen in Image 1 or a slight erosion which has a whitish center surrounded byinflamed red tissue seen in Image 2. In the severe cases, extensive deep ulcerations occur. Images 3and 4 show these ulcers.Benign Tumors of the Esophagus Image 1Esophageal PolypA polyp is a growth. Most polyps are benign but certain types can become malignant. They canoccur anywhere in the intestinal tract, especially the colon. Infrequently, they develop in theesophagus. They are rather easy to remove through the endoscope. This 1 inch polyp in the loweresophagus was an incidental finding. The whitish material is coagulated saliva. On pathology exam,it was a benign adenoma type polyp.
Duodenal Ulcer Image 1 Image 2 Image 3Examples of Duodenal UlcerUlcers often occur within the duodenum, usually in the first part just beyond the stomach which iscalled the duodenal cap. Ulcers can come in all shapes and sizes. Image 1 shows a single white-based ulcer. Image 2 shows numerous small ulcers scattered across the duodenal cap. Image 3demonstrates a huge duodenal ulcer almost filling the cap. Note the brownish areas across thewhitish base which is caused by some old blood. Some fresh bleeding is seen at the edge. Duodenalulcers are caused by the bacteria, Helicobacter pylori, or by arthritis medications such as Advil,Motrin, Naprosyn, aspirin and many others. All of these ulcers healed under appropriate therapy.
Duodenal Tumors Image 1Lymphoid PolyposisThis is a benign but peculiar looking condition. The intestine is packed with lymphoid tissue whichis necessary as part of the bodys immune system which protects us from infection. Most of theintestinal lymph deposits are below the surface and not usually seen. In this instance, the duodenumis full of these benign lymph nodules. They cause no problem and do not need treated. They are justan endoscopic oddityMalignant Tumors Image 1 Image 2 Image 3 Image 4Colon CancerMost cancers in the colon originate in adenoma type polyps. These adenomas start out being benign.Then, as they get larger, they can become cancerous. That is why polyps are always removed fromthe colon when they are found. Cancers come in all sizes. Image 1 shows a small cancerous polypabout the size of an olive. The chance for a complete cure in this case is probably very good. Image2 shows the same site after the polyp has been removed with cautery. The base of the polyp looks
nice and clean. Images 3 and 4 show more advanced cancers in the rectum and cecum or right colonrespectively. At this point, surgery is needed to remove the diseased segment of colon.Diverticular Disease Image 1 Image 2Diverticular Inflammatory Bowel DiseaseThis is an unusual condition. Please review the information on diverticulosis first, so you know whatdiverticuli are. Inflammatory bowel disease is a chronic inflammation of the bowel lining. It may becalled either ulcerative colitis or Crohns disease. A third type of inflammation can occur with severediverticulosis. The lining can become very reddened and then bleed. In these cases, theinflammation remains localized in the area with diverticulosis and never extends further. Treatmentis usually the same as for ulcerative colitis or Crohns disease. Here you see two images of thesigmoid colon. Image 1 a shows small black opening of a diverticuli on the left. Above it is themarkedly reddened and inflamed fold. Image 2 shows scattered areas of inflammation.