Clinical Science Session

gastritis ulceratif

Neneng Halimatusadiah
12100116002
Ulkus Lambung / gastritis ulceratif

Adalah erosi lapisan mukosa pada lambung

Terjadi paling banyak di kurva minor, walaupun bisa berasal dari semua
bagian
Endoskopi adalah teknik pemeriksaan yang lebih disukai walau
pemeriksaan dengan barium juga akurat
Gejala: mual, anoreksia, muntah, penurunan BB, nyeri abdomen atas,
berbagai komplikasi seperti perforasi, hematemesis, melena
Etiologi

Infeksi bakteri H. Pylori

Obat-obatan (OAINS - Obat Anti Inflamasi Non Steroid, Aspirin, Digitalis)
Obat ini menurunkan sekresi HCO3- sehingga perlindungan pada mukosa
menjadi lemah dan mukosa menjadi rusak.
trauma (pemasangan NGT, endoskopi,radiasi, dll.)
Hipersekresi asam pada saluran pencernaan
Perokok berat
Peminum alkohol,kafein
Patofisiologi
Radiologis Ulkus Lambung
Pem. Barium
pandangan en face (dari depan) memperlihatkan kolam barium yang terkumpul pada
kawah ulkus pada dinding yang terkena, dengan lipatan mukosa yang menyebar
mengelilingi ulkus
pandangan en profile (dari samping) ulkus tampak sebagai kantung yang keluar dari
dinding lambung

Hampton Line:garis lurus tipis 1 mm di leher ulkus di tampilan on profile

yang mewakili tepi tipis mukosa lambung yang rusak
 Ulkus jinak

lipatan menyebar dengan rata, dan proyeksi ulkus berada di luar dinding
lambung
Ulkus ganas

ulkus yang dangkal, kontur yang iregular, tidak menonjol melebihi batas
labung
Gastric ulcer: profile view showing an
outpouching from the lesser curve.
Barium meal demonstrates a giant gastric ulcer in profile. It is arising from the greater
curvature of the pyloric antrum, has a deep but smooth ulcer crater, protrudes beyond the
expected gastric contour, and has a prominent ulcer mound
Benign. lesser curvature gastric ulcer. Red arrows point to Hampton's Line, a thin,
straight line at neck of ulcer in profile view which represents the thin rim of undermined
gastric mucosa.
Malignant gastric ulcer - Carman's meniscus sign. There is a large ulcerating mass (arrows)
along the lesser curvature aspect of the gastric antrum
Upper GI series showing the differences between a malignant and benign gastric ulcer. Left
panel: Malignant gastric ulcer of the distal lesser curvature. There is the biconvex meniscus
sign with a nodular ulcer mound (arrow). Right panel: Benign gastric ulcer of the lesser
curvature. The ulcer crater has smooth margins and projects beyond the gastric wall
(arrow).
Barium meal demonstrates the giant gastric ulcer
en face.
Ulkkus lambung raksasa dengan lipatan mukosa
yang menyebar kedalam ulkus
Coned-down image of the gastric
antrum obtained during the single- Erosive gastritis with scalloped antral
contrast phase of the same double- folds. Several erosions (arrows) can be seen
contrast upper GI series shows on the crest of a scalloped fold.
numerous 1-3 mm punctate, ovoid, or
linear barium collections surrounded by
5 mm radiolucent halos
H. pylori causing diffuse polypoid
gastritis. Markedly thickened, lobulated
folds are seen in the gastric body. This
appearance could be mistaken for severe
hypertrophic gastritis, Mntrier's
disease, or lymphoma, but endoscopic
biopsy specimens revealed H. pylori
gastritis without evidence of tumor.
H. pylori causing localized polypoid
gastritis. Focally thickened, lobulated folds
are seen in the gastric body (arrows). These
findings are worrisome for a localized
lymphoma or submucosally infiltrating
carcinoma. In this patient, however,
endoscopic biopsy specimens revealed H.
pylori gastritis without evidence of tumor.
 Erosive gastritis caused by a nonsteroidal
anti-inflammatory drug
Erosive gastritis with scalloped
(Naproxen).Distinctive linear and
antral folds. Several erosions
serpiginous erosions are clustered in the
(arrows) can be seen on the crest of a
body of the stomach near the greater
scalloped fold.
curvature as a result of NSAID ingestion. The
patient was taking naproxen
TERIMA KASIH
WASSALAM