Difference between revisions of "Stomach"

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312 bytes added ,  15:38, 23 April 2013
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===Microscopic===
===Microscopic===
Features:
Features:
*''Helicobacter pylori'':
*Helicobacter organisms - '''key feature'''.
**Usually have v-shape (seagull-like shape).   
**''Helicobacter pylori'':
***May have a curved shape (comma-like shape) or U-shape.<ref name=pmid21290743>{{Cite journal  | last1 = Mobley | first1 = HLT. | last2 = Mendz | first2 = GL. | last3 = Hazell | first3 = SL. | last4 = Andersen | first4 = LP. | last5 = Wadström | first5 = T. | title = Basic Bacteriology and Culture | journal =  | volume =  | issue =  | pages =  | month =  | year =  | doi =  | PMID = 21290743 | url = http://www.ncbi.nlm.nih.gov/books/NBK2444/}} </ref>
***Usually have v-shape (seagull-like shape).   
*''Helicobacter heilmannii'':<ref name=pmid16224223 >{{Cite journal  | last1 = Singhal | first1 = AV. | last2 = Sepulveda | first2 = AR. | title = Helicobacter heilmannii gastritis: a case study with review of literature. | journal = Am J Surg Pathol | volume = 29 | issue = 11 | pages = 1537-9 | month = Nov | year = 2005 | doi =  | PMID = 16224223 }}</ref>
****May have a curved shape (comma-like shape) or U-shape.<ref name=pmid21290743>{{Cite journal  | last1 = Mobley | first1 = HLT. | last2 = Mendz | first2 = GL. | last3 = Hazell | first3 = SL. | last4 = Andersen | first4 = LP. | last5 = Wadström | first5 = T. | title = Basic Bacteriology and Culture | journal =  | volume =  | issue =  | pages =  | month =  | year =  | doi =  | PMID = 21290743 | url = http://www.ncbi.nlm.nih.gov/books/NBK2444/}} </ref>
**Corkscrew appearance.
**''Helicobacter heilmannii'':<ref name=pmid16224223 >{{Cite journal  | last1 = Singhal | first1 = AV. | last2 = Sepulveda | first2 = AR. | title = Helicobacter heilmannii gastritis: a case study with review of literature. | journal = Am J Surg Pathol | volume = 29 | issue = 11 | pages = 1537-9 | month = Nov | year = 2005 | doi =  | PMID = 16224223 }}</ref>
***Corkscrew appearance.
*Inflammation - usually ''moderate chronic active''.
**Clusters of (lamina propria) [[plasma cell]]s.
**[[Neutrophil]]s, numerous, classically intraepithelial.


Tips:
Tips:
*One needs to look at 400x magnification. Even at 400x they are possible to miss.
#One needs to look at 400x magnification. Even at 400x they are possible to miss.
**Helicobacter are damn small. They are smaller than the nucleus of the gastric foveollar cell.
#*Helicobacter are damn small. They are smaller than the nucleus of the gastric foveollar cell.
*Look for mucus - they preferentially reside there.
#Look for mucus - they preferentially reside there.
**This is usually close to the opening of the gastric pits.
#*This is usually close to the opening of the gastric pits.
*Helicobacter are found in groups. When you see several that are the same size and shape you can be sure they are real.
#Helicobacter are found in groups. When you see several that are the same size and shape you can be sure they are real.


Notes:
Notes:
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DDx:
DDx:
*Dirt - variable size.
*Dirt - material has a variable size.
*Contamination from oropharynx - bacilli straight, not associated with gastric mucosa.


Images:  
Images:  
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