Crohn Ménétrier This rare idiopathic disease affects adults aged between 30 and 60 years and is more common in men. The disease manifests as significant thickening of gastric mucosal folds in the body, but not in the antrum. There is a Drüsenatrophie and an eye-catching foveolar hyperplasia, often along with a goblet and a mucosal thickening with relatively little inflammation. There may be a hypoalbuminemia (the most consistent pathological laboratory finding) are caused by gastrointestinal protein loss (Eiweißverlustgastropathie). Advances this disease decreases the secretion of acid and pepsin and creates a Hypochlorhydria. The symptoms are not specific and generally include epigastric pain, nausea, weight loss, edema and diarrhea one. The Differential diagnosis includes first lymphomas in which multiple gastric ulcers can occur 2. mucosa associated lymphoid lymphomas (MALT) with dense infiltration of monoclonal B lymphocytes, 3. Zollinger-Ellison syndrome associated with hypertrophy of gastric folds and fourth Cronkhite-Canada- syndrome with polypoid mucosal changes and protein loss syndrome with diarrhea. The diagnosis is made endoscopically using a deep mucosal biopsy or laparoscopic biopsy of the pathological changes. Various treatments have been used, incl. Anticholinergics, anti-secretory drugs and corticosteroids, but none has proven effective as sufficient. A partial or complete gastric resection is indicated in severe cases of hypoalbuminemia. Eosinophilic gastritis A pronounced infiltration of the mucosa, submucosa and muscle layer with eosinophils often occurs in the antrum. It is usually idiopathic and may occur in nematode infestation. Symptoms include nausea, vomiting and early satiety. The diagnosis is made by an endoscopically obtained biopsy from the affected regions. Treatment with corticosteroids can be effective in the idiopathic cases, however, when developing a relocation of the pylorus, is indicated surgical intervention generally. Mucosa-associated lymphoid lymphoma (MALT) This rare disease is similar by a massive lymphoid infiltration of the gastric mucosa characterizes the disease in Ménétrier. Gastritis in systemic diseases sarcoidosis, tuberculosis, amyloidosis and other granulomatous diseases can lead to gastritis, which then but is rare in these diseases in the foreground. Gastritis by physical causes radiation and absorption of chemically corrosive substances (v. A. Those with acid compounds) can cause gastritis. Full body radiation (radiation exposure and contamination) with> 6 Gy cause a pronounced deep gastritis, which more typically affects the antrum than the corpus. Pyloric stenosis and perforation are possible complications of radiation-induced gastritis. Infectious (septic) gastritis With the exception of H. pylori infection is a bacterial invasion of the stomach is a rarity, it can after ischemia, after ingestion of corrosive substances or after irradiation occur. On the X-ray image shows a Gasödem the mucosa. The disease can manifest as an acute surgical abdomen and has a high mortality rate. An operative intervention is usually necessary. Debile or immunocompromised patients may develop a viral or fungal gastritis with cytomegalovirus, Candida, histoplasmosis, or mucormycosis; these analyzes should be considered with an exudative gastritis, esophagitis or duodenitis in patients.

Health Life Media Team

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