Digestive System
Can you enjoy your life without your
digestive system?
Characteristics of Digestive System
? Taking in energy sources
Digestion energy
tissue
absorption waste
? Numerous organs
Indiretly contact with outside
environment
Food→
Pathogenic factors→
(physical,chemical,microbial)
Common Lesions
inflammation
Ulcer
bleeding
perforation
neoplasm
functional disturbances
inflammation erosion ulcer
bleeding perforation tumor
Characteristics of Digestive System
? Not only a digestive organ but also
? endocrine organ
pancreas gastrin
glucagon
somatostatin
VIP
insulin
Characteristics of Digestive System
? Immune organ
mucosa,submucosa
lymhatic system
Liver
?Unique neurologic system
vagus
sympathetic
mesenteric plexus
Relation with other systems
Diseases Symptom
Esophagus inflammation dysphagia,heartburn
cancer
achalasia
GERD
Stomach inflammation upper abdominal discomfort
ulcer pain,anorexia,acid reflux
cancer nausea,vomitting,hematemesis
functional dyspepsia melena
Small intestine
inflammation pericembilical pain
(bacterial,virus T.B) distention diarrhea
bleeding,necrosis malabsorption
ulcer,(Crohn’s)
cancer(rare)
Colon inflammation abdominal pain (lateral)
(dysentry,non specific) constipation diarrhea
ulcer hematochezia
cancer
Disease Symptom
Liver inflammation hepatic area discomfort
(hepatitis abcess) pain,hepatomegaly
cirrhosis tenderness,jaundice
cancer portal hypertension
Biliary tract colicky
inflammation jaundice
stone,parasite,tumor
Disease Symptom
pancreas inflammation upper abdominal pain
cancer jaundice
malabsorption
Peritoneal mesenteric abdominal pain
inflammation tenderness
(T.B) ascites
cancer(metastatic)
Diagnosis & differential Diagnosis
? History
main symptoms:pain (example)
site,time and mode of onset
frequency and duration,character
severity,radiation,aggravating factors
relieving factors
Diagnosis & differential Diagnosis
? Signs,
inspection→auscultation→percussion→
palpation organ? Mass?
abdominal wall? In abdomen?
you palpate liver?
or
Liver palpate you?
digital rectal examination
? Other Exaninations
blood,liver test,(TB.CB,ALT.AST,A.G,ALP,PT)
liver function test,
virus markers (hepatitis, ABCDE,etc)
tumor markers (CEA,CA19-9,CA125…)
feces,routine,occult blood,parasites
X Ray,plain film
barium meal examination
barium enema
PTCD
ERCP
radio-Angiogram,DSA
Biopsy,mucosa,Liver,pancreas
CT
Endoscopy (Diagnosis & treatment)
Can reach almost all lumene of digestive tract,
capsule endoscope
Ultrasonography,endoscopic ultrasonography
Isotope examination biliary excretion
gastric emptying
13c,14c-UBT
MRI,MRCP
PET
Progress in the diagnosis and
treatment of digestive disease
Medical treatment of peptic ulcer (H2 RA PPI)
Bleeding of gastrointestinal tract endoscopy
Pathogenesis and treatment of gastrointestinal motility
disorder (FD,IBS…)
Experimental and clinical study in hepatic fibrosis
The treatment of portal hypertension (medical,endoscopy)
Artificial liver support system MARS
Liver transplantation
Diagnosis and treatment of malignancy
Have had progress but no breakthrough
Reasonable application of examination
? Indication
? The strength and weakness of every
examination
? Not the more up-to-the-minute
the better
