The digestive system. Medicine and technology. Normal structure and function Diagnostic methods Example diseases and therapies

Transcription

1 The digestive system Medicine and technology Normal structure and function Diagnostic methods Example diseases and therapies

2 The digestive system An overview (1) Oesophagus Liver (hepar) Biliary system Pancreas Stomach Duodenum Small intestine Large intestine Rectum

3 The digestive system An overview (2) Nerve plexa Mucosa Inner muscle layer Outer muscle layer Mesentery

4 The digestive system Blood flow

5 The digestive system Nerve supply

6 The digestive system The four basic functions Motility Regulation Secretion Digestion Absorption

7 Motility

8 Secretion og absorption

9 Digestion and absorption

10 Regulation Luminal Endocrine Nervous Paracrine

11 The digestive system Main diagnostic methods Basic clinical examination Radiology Endoscopies Other methods

12 Gastrointestinal radiology - basic (1)

13 Gastrointestinal radiology - basic (2) CT upper abd-normal Ultrasound upper abd-normal

14 Gastrointestinal endoscopy - basic (1)

15 Gastrointestinal endoscopy - basic (2) Biopsy forceps Snare Hemoclip

16 Gastrointestinal endoscopy - Taking a biopsy -

17 Gastrointestinal endoscopy the diatermy principle Both mono- and bipolar systems can be used for cutting or coagulation or as mixed modes Coagulation mode Interrupted current (50-100) Square pulses Cutting mode Continous current Sinus mode

18 Other methods one example (1a) Small intestinal examination - enterocapsule

19 Other methods another example (1b) Small intestinal examination ballon enteroscope

20 Other methods yet another example (2a) Manometry and ph in the oesophagus

21 Other methods the latest for ph (2b) Wireless logging of ph in the oesophagus

22 Oesophagus, stomach and duodenum

23 Oesophagus (1) - normal

24 Oesophagus (2) reflux oesophagitis Oesophagitis Barrett Stenosis

25 Oesophagus (3) reflux oesophagitis - Laparoscopic surgery -

26 Oesophagus (4) reflux and stricture - Endoscopic dilatation -

27 Oesophagus (5) - cancer

28 Oesophagus (6) - cancer - Staging by endoscopic ultrasound - Normal ultrasound image Lymph node metastasis M SM MP S

29 Oesophagus (7) - cancer - Palliative stenting -

30 Stomach normal anatomy

31 Stomach normal endoscopy

32 Gastric ulcer (1)

33 Gastric ulcer (2) The major complications Bleeding Perforation Obstruction

34 Gastric ulcer (3) bleeding Arterial bleeding Injection therapy The hemoclip

35 Gastric ulcer (4) argon plasma

36 Gastric ulcer (5) - perforation

37 Gastric ulcer (6) - obstruction

38 The cause of the classic peptic ulcer Helicobacter pylori Eradication (A) or not (B)

39 Gastric cancer (1) - diagnosis

40 Gastric cancer (2) - therapy

41 Duodenum (normal)

42 Duodenum (ulcer)

43 Duodenum (what is this?)

44 The small intestine

45 The normal small intestine Barium double contrast X-ray

46 Crohn s disease of the small intestine Barium X-ray Enteroscopy

47 Diagnosis by capsule endoscopy Bleeding Stricture

48 Patient with weight loss and diarrhea (1) Healthy person This patient

49 Patient with weight loss and diarrhea (2) Healthy person

50 Large intestine and rectum

51 Large intestine normal anatomy

52 Rectum normal anatomy

53 The appendix

54 Laparoscopic appendectomy An example of minimally invasive surgery

55 Ulcerative colitis

56 Polyps of the colon and polypectomy

57 Cancer of the colon Colonoscopy X-ray

58 Cancer of the colon surgical assessment

59 Liver and the biliary system

60 Liver (1) normal

61 Liver (2) normal

62 Liver (cirrhosis)

63 Liver (portal hypertension) Endoscopy Schematic Band ligation

64 Regional anatomy of the Duodenum-pancreas-biliary system

65 Ultrasound gallbladder

66 Papilla Vateri From above From below

67 Endoscopic findings - papilla Vateri Hemobilia Cancer Cholangitis

68 Biliary cannulation through the papilla Vateri

69 Endoscopic papillotomy (1)

70 Endoscopic papillotomy (2) Cannulation Incision

71 Stone extraction

72 ERCP, papillotomy, stone extraction

73 Stent - malignant obstruction of the bile ducts (1)

74 Stent - malignant obstruction of the bile ducts (2)