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Lecture no: 7
• Module: gastrointestinal and hepatobiliary system
• Topic: Intestinal pathologies—obstruction and diarrhea
• Date: 16-03-2020
• Presenter: Dr Zahid Mahmood Akhtar, Assistant Professor Pathology
INTESTINAL OBSTRUCTIONS
• 80%-HERNIAS(MOST FREQUENT), ADHESIONS,
VOLVULUS(COMMONLY SIGMOID COLON),
INTUSSUSCEPTION(COMMONEST IN CHILDREN YOUNGER THAN 2
YEARS)
• 15%- TUMORS, INFARCTION, STRICTURES
INTESTINAL OBSTRUCTION
CELIAC DISEASE
• GLUTEN(GLIADIN) IN WHEAT RYE AND BARLEY -SENSITIVITY
ENTEROPATHY IN GENETICALLY PREDISPOSED INDIVIDUALS
• IMMUNE MEDIATED
• CD8+ INTRAEPITHELIAL T LYMPHOCYTES
• NGK2D, IL-15 AND MIC-A
• ANTIBODIES
• BIOPSY FROM 2ND PORTION OF DUODENUM OR PROXIMAL JEJUNUM
• MICROSCOPY-VILLOUS ATROPHY, CRYPT HYPERPLASIA AND
INCREASED INTRAEPITHELIAL LYMPHOCYTES
CELIAC DISEASE
CELIAC DISEASE
CELIAC DISEASE
CELIAC DISEASE(COMPLICATIONS)
• ENTEROPATHY ASSOCIATED T CELL LYMPHOMA
• SMALL INTESTINAL ADENOCARCINOMA
GIARDIA LAMBLIA
• MOST COMMON PARASITIC PATHOGEN
• FLAGELLATED PROTOZOAN
• DUODENAL BIOPSY
• PEAR SHAPED
GIARDIASIS
ISCHEMIC BOWEL DISEASE
• ARTERIAL-ATHEROSCLEROSIS, AORTIC ANEURYSM,ORAL
CONTRACEPTIVE, HYPERCOAGULABLE STATE,EMBOLISATIONS OF
CARDIAC ATHEROMA AND CARDIAC VEGETATIONS
• INTESTINAL HYPOPERFUSION- CARDIAC FAILURE,
SHOCK,DEHYDRATION,VASOCONSTRICTIVE DRUGS
• VENOUS- INVASIVE NEOPLASMS, CIRRHOSIS
ISCHEMIC BOWEL DISEASE
ISCHEMIC BOWEL DISEASE
ACUTE ISCHEMIC COLITIS
AMEBIC ULCER
• COMMONLY EFFECT CECUM AND ASCENDING COLON
• FLASK SHAPED ULCER
AMEBIC ULCER
AMEBIASIS(PROTOZOA CONTAINING RBC)
PSEUDOMEMBRANOUS COLITIS
• GENERALLY CAUSED BY CLOSTRIDIUM DIFFICILE)—ANTIBIOTIC
ASSOCIATED COLITIS
• RISK FACTORS—ADVANCED AGE, HOSPITALIATION, ANTIBIOTIC
TREATMENT
PSUEDOMEMBRANOUS COLITIS
PSUEDOMEMBRANOUS COLITIS
CRYPTOSPORIDIUM
• IN AIDS PATIENTS AND ALSO IN IMMUNOLOGICALLY NORMAL
PERSONS
• SPOROZOITE IS INTRACELLULAR
• USUALLY INVOLVES TERMINAL ILEUM AND PROXIMAL COLON
• H/O CHRONIC DIARRHEA
CRYPTOSPORIDIUM

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Intestinal Pathologies - Obstruction and Diarrhea by Dr. Zahid Mahmood Akhtar (16.03.2020).pptx