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



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Transcription:

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

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

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

The digestive system Blood flow

The digestive system Nerve supply

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

Motility

Secretion og absorption

Digestion and absorption

Regulation Luminal Endocrine Nervous Paracrine

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

Gastrointestinal radiology - basic (1)

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

Gastrointestinal endoscopy - basic (1)

Gastrointestinal endoscopy - basic (2) Biopsy forceps Snare Hemoclip

Gastrointestinal endoscopy - Taking a biopsy -

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

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

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

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

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

Oesophagus, stomach and duodenum

Oesophagus (1) - normal

Oesophagus (2) reflux oesophagitis Oesophagitis Barrett Stenosis

Oesophagus (3) reflux oesophagitis - Laparoscopic surgery -

Oesophagus (4) reflux and stricture - Endoscopic dilatation -

Oesophagus (5) - cancer

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

Oesophagus (7) - cancer - Palliative stenting -

Stomach normal anatomy

Stomach normal endoscopy

Gastric ulcer (1)

Gastric ulcer (2) The major complications Bleeding Perforation Obstruction

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

Gastric ulcer (4) argon plasma

Gastric ulcer (5) - perforation

Gastric ulcer (6) - obstruction

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

Gastric cancer (1) - diagnosis

Gastric cancer (2) - therapy

Duodenum (normal)

Duodenum (ulcer)

Duodenum (what is this?)

The small intestine

The normal small intestine Barium double contrast X-ray

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

Diagnosis by capsule endoscopy Bleeding Stricture

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

Patient with weight loss and diarrhea (2) Healthy person

Large intestine and rectum

Large intestine normal anatomy

Rectum normal anatomy

The appendix

Laparoscopic appendectomy An example of minimally invasive surgery

Ulcerative colitis

Polyps of the colon and polypectomy

Cancer of the colon Colonoscopy X-ray

Cancer of the colon surgical assessment

Liver and the biliary system

Liver (1) normal

Liver (2) normal

Liver (cirrhosis)

Liver (portal hypertension) Endoscopy Schematic Band ligation

Regional anatomy of the Duodenum-pancreas-biliary system

Ultrasound gallbladder

Papilla Vateri From above From below

Endoscopic findings - papilla Vateri Hemobilia Cancer Cholangitis

Biliary cannulation through the papilla Vateri

Endoscopic papillotomy (1)

Endoscopic papillotomy (2) Cannulation Incision

Stone extraction

ERCP, papillotomy, stone extraction

Stent - malignant obstruction of the bile ducts (1)

Stent - malignant obstruction of the bile ducts (2)