DIGESTIVE SYSTEM DISEASES (LIVER, GALL BLADDER & PANCREAS)
DEVELOPMENTAL ABNORMALITIES 1) Cystic Fibrosis Cause: Autosomal recessive genetic defect Lesion: Mucus plugging of pancreatic duct Fibrosis of pancreatic parenchyma Manifestations: Malabsorption syndrome Weight loss Pancreatic insufficiency INFLAMMATORY AND DEGENERATIVE DISEASES 1) Viral enteritis Causes: Hepatitis A virus Hepatitis B virus Non A Non B viruses Lesions: Necrosis and swelling of hepatocytes Inflamed liver Manifestations: Anorexia Malaise Jaundice Enlarged tender liver High AST (Aspartate aminotransferase) 2) Chemical injuries to the liver Cause: Hypersensitivity to drugs Chemical action of drugs or toxic chemicals Lesion: Inflamed liver with necrosis Manifestations: Jaundice Abnormal liver lab test values History of exposure to agent
3) Alcoholic liver disease Cause: Alcoholism Lesions: Fatty necrosis Alcoholic hepatitis Fibrosis Finely nodular fatty cirrhosis Manifestations: Long history of heavy alcohol intake Enlarged liver Altered liver function Findings of cirrhosis 4) Cirrhosis Causes: Alcoholism Viral hepatitis Unknown causes Bile duct obstruction Hemochromatosis Wilson=s disease Alpha-1-antitrypsin deficiency Lesions: Fibrotic bands Regenerating nodules of hepatocytes Manifestations: Jaundice Hepatic encephalopathy Bleeding esophageal varices Ascities Spider angiomas Gynecomastia Cirrhosis by biopsy 5) Cholecystitis and gallstones Cause: Unknown; strong association with increasing age and higher incidence in females Lesions: Gallstones Mild chronic inflammation Manifestations: Usually none Pain after meals Obstruction of bile duct with jaundice Acute cholecystitis with pain, fever and leucocytosis
6) Pancreatitis Causes: Alcoholism Gallstones Trauma Lesions: Enzymatic necrosis of pancreas and surrounding fatty tissue Fibrosis (chronic) Manifestations: Abdominal pain Malabsorption (late) Diabetes mellitus (late) HYPERPLASTIC / NEOPLASTIC DISEASES 1) Metastatic cancer of the liver Cause: Cancer of abdominal and other organs Lesion: Multiple nodules of cancer in the liver Manifestations: May be none Hepatomegaly Jaundice (late) Nodular liver Cancer on biopsy 2) Carcinoma of the pancreas Cause: Unknown Lesion: Adenocarcinoma of head or tail of pancreas Manifestations: Jaundice Weight loss Pain