Diseases of the stomach

image of Diseases of the stomach
Online Access: £ 25.00 + VAT
BSAVA Library Pass Buy a pass



The stomach functions as a reservoir that controls the size and rate of passage of ingesta into the small intestine, and initiates the digestion of protein and fat, and the absorption of vitamins and minerals. The stomach is made up of four functional regions: the cardia, fundus, body and antrum. The fundus and body expand to accommodate ingesta. The antrum is thick and muscular and grinds food into small particles that are triturated into the duodenum. The pyloric sphincter controls efflux into the duodenum, and the lower oesophageal sphincter prevents reflux of ingesta into the oesophagus. This chapter looks into Structure and function; Diagnostic approach; Evaluating gastric function; and Diseases of the stomach.

Preview this chapter:
Loading full text...

Full text loading...



Image of 19.1
19.1 Functional anatomy of the stomach. Inset A = fundic mucosa; Inset B = pyloric mucosa showing gastrin-positive cells stained brown.
Image of 19.2
19.2 Regulation of acid secretion. ACh = acetylcholine receptor; ATPase = adenosine triphosphatase; ECL = enterochromaffin-like cell; GRP = gastrin-releasing peptide; H = histamine H receptor and PGE = prostaglandin E receptor. (Reproduced from ; © Kenneth Simpson. With permission from the publishers)
Image of 19.3
19.3 -associated gastritis. infection is best diagnosed from impression smears or biopsy samples. (a) Numerous spiral organisms are visible in this Diff-Quik-stained impression smear of gastric juice. (b) Modified Steiner-stained, formalin-fixed, paraffin-embedded biopsy sample showing organisms stained dark blue. (c) Lymphoid follicle hyperplasia and lymphocytic gastritis in a cat with -associated gastritis (H&E stain). The significance of infection is based on the presence of histopathological changes on biopsy.
Image of 19.7
19.7 Contrast radiographic evaluation of a dog presented for investigation of chronic vomiting. (a) Survey radiographs show a soft tissue density in the antrum (arrowed). (b and c). Left lateral and ventrodorsal radiographs show retention of liquid barium contrast, revealing the presence of a mass in the pyloric outflow tract (arrowed).
Image of 19.8
19.8 Imaging of the stomach with ultrasonography and endoscopy provides complementary information. The ultrasonogram shows a mass projecting into the lumen of the stomach of a dog presented for the investigation of vomiting and hyperglobulinaemia (IgA). Endoscopy confirmed the presence of a mass and enabled a biopsy diagnosis of gastric plasmacytoma.
Image of 19.10
19.10 Hypersecretion of gastric acid can be caused by decreased elimination of gastrin in patients with renal failure, or the excessive production of histamine from mast cell tumours or gastrin from gastrinomas. Renal failure should be detected by measuring the serum creatinine concentration and urine specific gravity. Cutaneous masses and an enlarged spleen should be aspirated for evidence of mast cells. (a) Fine needle aspirate of a cutaneous mass on a dog with vomiting associated with mastocytosis showing round cells containing cytoplasmic pink-stained granules. (b) Ultrasonographic detection of splenomegaly in a cat with chronic vomiting enabled fine needle aspiration and cytological diagnosis of mastocytosis. (c and d) Endoscopic appearance of (c) the oesophagus and (d) the pyloric antrum of a dog with a gastrinoma. Note the small multifocal haemorrhages and erythema in the oesophagus consistent with oesophagitis and mucosal erosion, and antral hypertrophy in the stomach. (e) Duodenal perforation in a dog with a pancreatic gastrinoma. (f) Gastrin-secreting mass (gastrinoma) found in the pancreas of a dog.
Image of 19.13
19.13 Gastric ulceration caused by ibuprofen before and after 1 week’s treatment with cimetidine and sucralfate.
Image of 19.14
19.14 Gastric ulceration associated with a gastric carcinoma. Note the mucosal thickening surrounding the ulcer compared with the NSAID-induced ulcer in Figure 19.13 .
Image of 19.15
19.15 Radiographic diagnosis of gastric dilatation (top row), and dilatation and volvulus (bottom row). Right and left lateral, and dorsoventral radiographs showing gastric compartmentalization with the pylorus (*) separated from the fundus by a soft tissue density in the lower row.
Image of 19.16
19.16 A standardized photographic scale for atrophy, fibrosis and cellular infiltrate. 0 = normal; 1 = mild; 2 = moderate; 3 = severe. (Reproduced from Wiinberg . (in press) with permission from the American College of Veterinary Internal Medicine)
Image of 19.17
19.17 Hypertrophic gastropathy. (a) Diffuse fundic hypertrophy. (b) Multifocal fundic hypertrophy. (c) Endoscopic view of antral mucosal hypertrophy. (d) Appearance of antral mucosal hypertrophy caused by spp. infection, resected at surgery.
Image of 19.19
19.19 Marked retention of barium in a cat with delayed gastric emptying associated with submucosal infiltration with neutrophils.
Image of 19.20
19.20 The use of barium impregnated polyethylene spheres (BIPS) to evaluate gastric emptying. This radiograph shows the accumulation of BIPS in the gastric body.
Image of 19.22
19.22 Benign gastric tumours. (a) An ulcerated gastric leiomyoma (arrowed) in the cardia of a dog. (b) Adenomatous polyp (arrowed) in the pyloric outflow tract of a dog.
Image of 19.23
19.23 Malignant gastric tumours. Endoscopic appearance of (a) diffuse gastric adenocarcinoma (arrowed), (b) focal gastric adenocarcinoma (arrowed) and (c) gastric lymphoma with infiltration of all rugae in the visual field.
This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error