University:
Saint Louis University
Course:
PATH 0100 | Introduction to Pathology
Academic year:

2024
Views:

212

Pages:

3
Author:

brian 11kizz

XIII. GASTRIC LYMP EXAMINATION : Objective : gastric motilitygastric acid secretion: HCl, enzymes Abnormal elements: blood, pus, fungi, bacteria Poison (Forensic)Bone cell cytology Material HOW TO SAKE SAMPLES • Prepare the Wangensteen sonde: flexible rubber pipe • The patient sits, inserts the probe through the mouth until it enters the stomach • The sonde is fixed with plaster • Prevent vomiting: cooled sonde or spray 1% lidocaine in the throatGastric Motility Method: • The patient fasted for 10 hours. • The sonde is inserted into the stomach, the stomach contents are removed • Measure stomach volume if: – 25 ml – 75 ml of liquid without food waste – If there are leftovers: the disorder inhibits gastric emptying – Vol > 75 ml: hypersecretion eg gastritis. Gastric Acidity Objective: to determine whether gastric HCl secretion is normal or not. Material: vomit material or material from the probe Ways of working Method: use litmus paper or Toepfer indicator Macroscopic Examination 1 Volume: • average 25 ml, can be up to 75 ml • Abnormal if > 100 ml could be due to hypersecretion, decreased gastric motility, obstruction Color: • Normal: pearl gray and slightly cloudy • Greenish (biliverdin), yellowish (bilirubin): regurgitation of duodenal contents, possibly partial obstruction2 Color Macroscopic Examination: • Pink: fresh blood, trauma when installing the probe or ulcer, carcinoma • Brown: old blood, because Hb becomes hematin acid • Other colors: due to drugs : Gastric Fluid • Smell: • Hard acid: gastric stasis • Rot: gastric necrosis • Stool: obstruction, fistula between the intestines and the stomach Macroscopic Examination of 3 Mucus: • Normal: pearl gray and slightly cloudy • Greenish (biliverdin), yellowish (bilirubin): regurgitation of duodenal contents, possibly partial obstruction Leftovers: • Normal: no food waste • Residual (+): decreased motility or pyloric obstructionMacroscopic Examination 4 EFA: • Normal: none • PUS (+): inflammation, infection, can come from the stomach, respiratory tract Network cutout: • Suspected tumor or trauma, further evaluation is needed MICROSCOPIC EXAMINATION Requirements: Patient is fasting Method: • 1 drop of gastric fluid is examined: erythrocytes, leukocytes, epithelial cells, food debris, tissue pieces, etc • 1 drop + sudan III: check for fat droplets • 1 drop + Lugol's lar: amylum granules • 1 drop + gram paint: - Sarcinae: large gram (+) cocci, arranged in fours, large numbers indicate stasis without achlorhydria - L. acidophilus (Bacillus Boas-Oppler): gram (+) rods, large, in groups or ends forming winding chains Attention • Gastric juice contains epithelium, leukocytes, erythrocytes, starch in small quantities • Sometimes it is difficult to determine whether the element comes from the stomach or other places such as the bronchus (lungs). • Culture: fasting gastric fluid is homogenized, rotated, the sediment is taken.