The document discusses various gastrointestinal dysfunctions and disorders including their clinical manifestations and pathophysiology. It covers conditions affecting the esophagus, stomach, small and large intestines, such as gastroesophageal reflux disease, peptic ulcers, irritable bowel syndrome, inflammatory bowel diseases, and malabsorption syndromes. It provides details on the symptoms, causes, and treatments of these common digestive disorders.

1. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 1
Alterations of Digestive Function

2. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 2
Clinical Manifestations of
Gastrointestinal Dysfunction
 Anorexia
 A lack of a desire to eat despite physiologic
stimuli that would normally produce hunger
 Vomiting
 The forceful emptying of the stomach and
intestinal contents through the mouth
 Several types of stimuli initiate the vomiting
reflex

3. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 3
Clinical Manifestations of
Gastrointestinal Dysfunction (cont’d)
 Nausea
 A subjective experience that is associated with
a number of conditions
 The common symptoms of vomiting are
hypersalivation and tachycardia
 Retching
 Nonproductive vomiting

4. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 4
Clinical Manifestations of
Gastrointestinal Dysfunction (cont’d)
 Projectile vomiting
 Projectile vomiting is spontaneous vomiting
that does not follow nausea or retching

5. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 5
Clinical Manifestations of
Gastrointestinal Dysfunction (cont’d)
 Constipation
 Constipation is defined as infrequent or difficult
defecation
 Pathophysiology
• Neurogenic disorders
• Functional or mechanical conditions
• Low-residue diet
• Sedentary lifestyle
• Excessive use of antacids
• Changes in bowel habits

6. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 6
Clinical Manifestations of
Gastrointestinal Dysfunction (cont’d)
 Diarrhea
 Increased frequency of bowel movements
 Increased volume, fluidity, weight of the feces
 Major mechanisms of diarrhea:
• Osmotic diarrhea
• Secretory diarrhea
• Motility diarrhea
 Associated with malabsorption syndromes

7. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 7
Clinical Manifestations of
Gastrointestinal Dysfunction (cont’d)
 Abdominal pain
 Abdominal pain is a symptom of a number of
gastrointestinal disorders
 Parietal pain
 Visceral pain
 Referred pain

8. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 8
Clinical Manifestations of
Gastrointestinal Dysfunction (cont’d)
 Gastrointestinal bleeding
 Upper gastrointestinal bleeding
• Esophagus, stomach, or duodenum
 Lower gastrointestinal bleeding
• Below the ligament of Treitz or bleeding from the
jejunum, ileum, colon, or rectum
 Hematemesis
 Hematochezia
 Melena
 Occult bleeding

9. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 9
Clinical Manifestations of
Gastrointestinal Dysfunction (cont’d)

10. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 10
Disorders of Motility
 Dysphagia
 Dysphagia is difficulty swallowing
 Types:
• Mechanical obstructions
• Functional obstructions
 Achalasia:
• Denervation of smooth muscle in the esophagus and
lower esophageal sphincter relaxation

11. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 11
Achalasia

12. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 12
Disorders of Motility
 Gastroesophageal reflux disease (GERD)
 GERD is the reflux of chyme from the stomach
to the esophagus
 If GERD causes inflammation of the
esophagus, it is called reflux esophagitis
 A normal functioning lower esophageal
sphincter maintains a zone of high pressure to
prevent chyme reflux

13. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 13
Disorders of Motility (cont’d)
 Gastroesophageal reflux disease (GERD)
(cont’d)
 Conditions that increase abdominal pressure
can contribute to GERD
 Manifestations:
• Heartburn
• Regurgitation of chyme
• Mid-epigastric pain within 1 hour of eating

14. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 14
Disorders of Motility (cont’d)
 Hiatal hernia
 Sliding hiatal hernia
 Paraesophageal hiatal hernia

15. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 15
Hiatal HerniaHiatal Hernia

16. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 16
Disorders of Motility
 Pyloric obstruction
 The blocking or narrowing of the opening
between the stomach and the duodenum
 Can be acquired or congenital
 Manifestations:
• Epigastric pain and fullness
• Nausea
• Succussion splash
• Vomiting
• With a prolonged obstruction, malnutrition,
dehydration, and extreme debilitation

17. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 17
Disorders of Motility (cont’d)
 Intestinal obstruction and paralytic ileus
 An intestinal obstruction is any condition that
prevents the flow of chyme through the
intestinal lumen or failure of normal intestinal
motility in the absence of an obstructing lesion
 An ileus is an obstruction of the intestines
 Simple obstruction
 Functional obstruction

18. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 18
Intestinal Obstruction

19. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 19
Gastritis
 Inflammatory disorder of the gastric
mucosa
 Acute gastritis
 Chronic gastritis
 Chronic fundal gastritis
 Chronic antral gastritis

20. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 20
Gastritis (cont’d)

21. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 21
Peptic Ulcer Disease
 A break or ulceration in the protective
mucosal lining of the lower esophagus,
stomach, or duodenum
 Acute and chronic ulcers
 Superficial
 Erosions
 Deep
 True ulcers
 Zollinger-Ellison syndrome

22. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 22
Peptic Ulcer Disease (cont’d)
 Duodenal ulcers
 Most common of the peptic ulcers
 Developmental factors:
• Helicobacter pylori infection
 Toxins and enzymes that promote inflammation and
ulceration
• Hypersecretion of stomach acid and pepsin
• Use of NSAIDs
• High gastrin levels
• Acid production by cigarette smoking

23. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 23
Duodenal Ulcer

24. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 24
Gastric Ulcer
 Gastric ulcers tend to develop in the antral
region of the stomach, adjacent to the
acid-secreting mucosa of the body
 Pathophysiology
 The primary defect is an increased mucosal
permeability to hydrogen ions
 Gastric secretion tends to be normal or less
than normal

25. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 25
Gastric Ulcer (cont’d)

26. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 26
Stress Ulcer
 A stress ulcer is a peptic ulcer that is
related to severe illness, neural injury, or
systemic trauma
 Ischemic ulcers
• Within hours of trauma, burns, hemorrhage, sepsis
 Cushing ulcers
• Ulcers that develop as a result of a head/brain injury

27. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 27
Postgastrectomy Syndromes
 Dumping syndrome
 Alkaline reflux gastritis
 Afferent loop obstruction
 Diarrhea
 Weight loss
 Anemia
 Bone and mineral disorders

28. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 28
Dumping Syndrome
 Dumping syndrome is the rapid emptying
of chyme from a surgically created residual
stomach into the small intestine
 Dumping syndrome is a clinical
complication of partial gastrectomy or
pyloroplasty surgery

29. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 29
Dumping Syndrome (cont’d)
 Developmental factors:
 Loss of gastric capacity
 Loss of emptying control
 Loss of feedback control by the duodenum
when it is removed
 Late dumping syndrome

30. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 30
Malabsorption Syndromes
 Maldigestion
 Failure of the chemical processes of digestion
 Malabsorption
 Failure of the intestinal mucosa to absorb
digested nutrients
 Maldigestion and malabsorption frequently
occur together

31. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 31
Malabsorption Syndromes (cont’d)
 Pancreatic insufficiency
 Insufficient pancreatic enzyme production
• Lipase, amylase, trypsin, or chymotrypsin
 Causes:
• Pancreatitis
• Pancreatic carcinoma
• Pancreatic resection
• Cystic fibrosis
 Fat maldigestion is the main problem, so the
patient will exhibit fatty stools and weight loss

32. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 32
Malabsorption Syndromes (cont’d)
 Lactase deficiency
 Inability to break down lactose into
monosaccharides and therefore prevent
lactose digestion and monosaccharide
absorption
 Fermentation of lactose by bacteria causes
gas (cramping pain, flatulence, etc.) and
osmotic diarrhea

33. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 33
Malabsorption Syndromes (cont’d)
 Bile salt deficiency
 Conjugated bile salts needed to emulsify and
absorb fats
 Conjugated bile salts are synthesized from
cholesterol in the liver
 Can result from liver disease and bile
obstructions
 Poor intestinal absorption of lipids causes fatty
stools, diarrhea, and loss of fat-soluble
vitamins (A, D, E, K)

34. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 34
Malabsorption Syndromes (cont’d)
 Fat-soluble vitamin deficiencies:
 Vitamin A
• Night blindness
 Vitamin D
• Decreased calcium absorption
• Bone pain
• Osteoporosis
• Fractures
 Vitamin K
• Prolonged prothrombin time
• Purpura
• Petechiae
 Vitamin E
• Uncertain

35. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 35
Inflammatory Bowel Diseases
 Chronic, relapsing inflammatory bowel
disorders of unknown origin
 Genetics
 Alterations of epithelial barrier functions
 Immune reactions to intestinal flora
 Abnormal T cell responses

36. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 36
Ulcerative Colitis
 Chronic inflammatory disease that causes
ulceration of the colonic mucosa
 Sigmoid colon and rectum
 Suggested causes:
 Infectious
 Immunologic (anticolon antibodies)
 Dietary
 Genetic (supported by family studies and
identical twin studies)

37. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 37
Ulcerative Colitis (cont’d)
 Symptoms:
 Diarrhea (10 to 20/day)
 Bloody stools
 Cramping
 Treatment:
 Broad-spectrum antibiotics and steroids
 Immunosuppressive agents
 Surgery
 An increased colon cancer risk
demonstrated

38. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 38
Crohn Disease
 Granulomatous colitis, ileocolitis, or
regional enteritis
 Idiopathic inflammatory disorder; affects
any part of the digestive tract, from mouth
to anus
 Difficult to differentiate from ulcerative
colitis
 Similar risk factors and theories of causation
as ulcerative colitis

39. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 39
Crohn Disease (cont’d)
 Causes “skip lesions”
 Ulcerations can produce longitudinal and
transverse inflammatory fissures that
extend into the lymphatics
 Anemia may result from malabsorption of
vitamin B12 and folic acid
 Treatment similar to ulcerative colitis

40. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 40
Diverticular Disease of the Colon
 Diverticula
 Herniations of mucosa through the muscle
layers of the colon wall, especially the sigmoid
colon
 Diverticulosis
 Asymptomatic diverticular disease
 Diverticulitis
 The inflammatory stage of diverticulosis

41. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 41
Appendicitis
 Inflammation of the vermiform appendix
 Possible causes:
 Obstruction, ischemia, increased intraluminal
pressure, infection, ulceration, etc.
 Epigastric and RLQ pain
 Rebound tenderness
 The most serious complication is
peritonitis

42. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 42
Irritable Bowel Syndrome
 A functional gastrointestinal disorder with
no specific structural or biochemical
alterations as a cause of disease
 Characterized by recurrent abdominal pain
and discomfort associated with altered
bowel habits that present as diarrhea or
constipation or both
 Associated with anxiety, depression, and
chronic fatigue syndrome

43. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 43
Irritable Bowel Syndrome (cont’d)
 Cause unknown but mechanisms
proposed:
 Visceral hypersensitivity
 Abnormal intestinal motility and secretion
 Intestinal infection
 Overgrowth of small intestinal flora
 Food allergy/intolerance
 Psychosocial factors

44. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 44
Irritable Bowel Syndrome (cont’d)
 Manifestations:
 Can be diarrhea-predominant or constipation-
predominant
 Alternating diarrhea/constipation, gas, bloating,
and nausea
 Symptoms are usually relieved with
defecation and do not interfere with sleep

45. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 45
Vascular Insufficiency
 Blood supply to the stomach and intestine
 Celiac axis
 Superior and inferior mesenteric arteries
 Two of three must be compromised to cause
ischemia
 Mesenteric venous thrombosis
 Acute occlusion of mesenteric artery blood
flow
 Chronic mesenteric arterial insufficiency

46. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 46
Obesity
 An increase in body fat mass
 Body mass index greater than 30
 A major cause of morbidity, death, and
increased health care costs
 Risk factor for many diseases and
conditions

47. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 47
Obesity (cont’d)
 Hypothalamus
 Hormones that control appetite and
weight:
 Insulin
 Ghrelin
 Peptide YY
 Leptin
 Adiponectin
 Resistin
 Leptin resistance
 Hyperleptinemia

48. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 48
Obesity (cont’d)

49. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 49
Anorexia Nervosa and Bulimia
Nervosa
 Characteristics:
 Abnormal eating behavior
 Weight regulation
 Disturbed attitudes toward body weight, body
shape, and size

50. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 50
Anorexia Nervosa and Bulimia
Nervosa (cont’d)
 Anorexia nervosa
 A person has poor body image disorder and
refuses to eat
 Anorexic patients can lose 25% to 30% of their
ideal body weight as a result of fat and muscle
depletion
 Can lead to starvation-induced cardiac failure
 In women and girls, anorexia is characterized
by the absence of three consecutive menstrual
periods
 Binge eating/purging anorexia nervosa

51. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 51
Anorexia Nervosa and Bulimia
Nervosa (cont’d)
 Bulimia nervosa
 Body weight remains near normal but with
aspirations for weight loss
 Findings
• Recurrent episodes of binge eating
• Self-induced vomiting
• Two binge-eating episodes per week for at least 3
months
• Fasting to oppose the effect of binge eating, or
excessive exercise

52. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 52
Anorexia Nervosa and Bulimia
Nervosa (cont’d)
 Bulimia nervosa (cont’d)
 Continual vomiting of acidic chyme can cause:
• Pitted teeth
• Pharyngeal and esophageal inflammation
• Tracheoesophageal fistulas
 Overuse of laxative can cause rectal bleeding

53. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 53
Malnutrition and Starvation
 Starvation
 Decreased caloric intake leading to weight loss
 Cachexia
 Short-term starvation
• Glycogenolysis
• Gluconeogenesis
 Long-term starvation
• Marasmus
• Kwashiorkor

54. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 54
Liver Disorders
 Portal hypertension
 Abnormally high blood pressure in the portal
venous system caused by resistance to portal
blood flow
• Prehepatic
• Intrahepatic
• Posthepatic

55. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 55
Liver Disorders (cont’d)
 Portal hypertension (cont’d)
 Consequences:
• Varices:
 Lower esophagus
 Stomach
 Rectum
• Splenomegaly
• Ascites
• Hepatic encephalopathy

56. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 56
Varices

57. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 57
Ascites

58. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 58
Ascites (cont’d)

59. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 59
Liver Disorders
 Hepatic encephalopathy
 A neurologic syndrome of impaired cognitive
function, flapping tremor, and EEG changes
 The condition develops rapidly during fulminant
hepatitis or slowly during chronic liver disease
 Cells in the nervous system are vulnerable to
neurotoxins absorbed from the GI tract that,
because of liver dysfunction circulate to the
brain

60. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 60
Liver Disorders (cont’d)
 Jaundice (icterus)
 Obstructive jaundice
• Extrahepatic obstruction
• Intrahepatic obstruction
 Hemolytic jaundice
• Prehepatic jaundice
• Excessive hemolysis of red blood cells or absorption
of a hematoma

61. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 61
Jaundice

62. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 62
Hepatorenal Syndrome
 Renal failure demonstrating oliguria,
sodium and water retention, hypotension,
and peripheral vasodilation as a result of
advanced liver disease

63. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 63
Viral Hepatitis
 Systemic viral disease that primarily
affects the liver
 Hepatitis A
• Formally known as infectious hepatitis
 Hepatitis B
• Formally known as serum hepatitis
 Hepatitis C, D, E, and G

64. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 64
Hepatitis A
 Hepatitis A can be found in the feces, bile,
and sera of infected individuals
 Usually transmitted by the fecal-oral route
 Risk factors:
 Crowded, unsanitary conditions
 Food and water contamination

65. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 65
Hepatitis B
 Transmitted through contact with infected
blood, body fluids, or contaminated
needles
 Maternal transmission can occur if the
mother is infected during the third trimester
 The hepatitis B vaccine prevents
transmission and development of hepatitis
B

66. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 66
Hepatitis C
 Hepatitis C is responsible for most cases
of post-transfusion hepatitis
 Also implicated in infections related to IV
drug use
 50% to 80% of hepatitis C cases result in
chronic hepatitis

67. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 67
Hepatitis
 Hepatitis D
 Depends on hepatitis B for replication
 Hepatitis E
 Fecal-oral transmission
 Developing countries
 Hepatitis G
 Recently discovered
 Parentally and sexually transmitted

68. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 68
Hepatitis (cont’d)
 Sequence:
 Incubation phase
 Prodromal (preicteric) phase
 Icteric phase
 Recovery phase
 Chronic active hepatitis
 Fulminant hepatitis
 Results from impairment or necrosis of
hepatocytes

69. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 69
Cirrhosis
 Irreversible inflammatory disease that
disrupts liver function and even structure
 Decreased hepatic function caused by
nodular and fibrotic tissue synthesis
(fibrosis)

70. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 70
Cirrhosis (cont’d)
 Biliary channels become obstructed and
cause portal hypertension
 Because of the hypertension, blood can be
shunted away from the liver, and a hypoxic
necrosis develops

71. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 71
Cirrhosis (cont’d)
 Alcoholic
 The oxidation of alcohol damages hepatocytes
 Biliary (bile canaliculi)
 Cirrhosis begins in the bile canaliculi and ducts
 Primary biliary cirrhosis (autoimmune)
 Secondary biliary cirrhosis (obstruction)

72. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 72
Cirrhosis (cont’d)

73. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 73
Disorders of the Gallbladder
 Obstruction or inflammation (cholecystitis)
is the most common cause of gallbladder
problems
 Cholelithiasis—gallstone formation
 Types:
• Cholesterol (most common)
• Pigmented (cirrhosis)
 Risks:
• Obesity
• Middle age
• Female
• Native American ancestry
• Gallbladder, pancreas, or ileal disease

74. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 74
Disorders of the Gallbladder
(cont’d)
 Gallstones
 Obstruction or inflammation (cholecystitis) is
the most common cause of gallbladder
problems
 Cholesterol stones form in bile that is
supersaturated with cholesterol
 Theories:
• Enzyme defect increases cholesterol synthesis
• Decreased secretion of bile acids to emulsify fats
• Decreased resorption of bile acids from ileum
• Gallbladder smooth muscle hypomotility and stasis
• Genetic predisposition
• Combination of any or all of the above

75. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 75
Gallstones

76. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 76
Disorders of the Pancreas
 Pancreatitis
 Inflammation of the pancreas
 Associated with several other clinical disorders
• Caused by an injury or damage to pancreatic cells
and ducts, causing a leakage of pancreatic enzymes
into the pancreatic tissue
These enzymes cause autodigestion of
pancreatic tissue and leak into the
bloodstream to cause injury to blood
vessels and other organs

77. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 77
Disorders of the Pancreas (cont’d)
 Pancreatitis (cont’d)
 Manifestations and evaluation:
• Epigastric pain radiating to the back
• Fever and leukocytosis
• Hypotension and hypovolemia
 Enzymes increase vascular permeability
• Characterized by an increase in a patient’s serum
amylase level
 Chronic pancreatitis
• Related to chronic alcohol abuse

78. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 78
Cancer of the Gastrointestinal
Tract
 Esophagus
 Stomach
 Colon and rectum
 Liver
 Gallbladder
 Pancreas

79. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 79
Stomach Cancer

80. Mosby items and derived items © 2012 Mosby, Inc., an imprint of Elsevier Inc. 80
Colon Cancer