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Samenvatting spijs 2 - deel 1
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samenvatting deel 1 (slokdarm, maag, ...)
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ABDOMEN 2 – SPIJSVERTERING DEEL 1INHOUDSOPGAVE
SLOKDARM- EN MAAGTUMOREN......................................................................................................3
RADIOLOGIE – OP DE BEECK..................................................................................................................3
PATHOLOGIE – DRIESSEN//....................................................................................................................4
DIAGNOSTIEK EN NIET-CHIRURGISCHE BEHANDELING – PEETERS....................................................................13
UPPER-GI CHIRURGIE – DE MAAT/........................................................................................................29
COLONKANKER................................................................................................................................36
RADIOLOGIE – OP DE BEECK................................................................................................................36
PATHOLOGIE – DRIESSEN.....................................................................................................................37
DIAGNOSTIEK EN NIET-CHIRURGISCHE BEHANDELING – PEETERS....................................................................43
DUNNE EN DIKKE DARMTUMOREN.........................................................................................................45
TUMORCHIRURGIE – KOMEN................................................................................................................48
SLOKDARMPATHOLOGIE.................................................................................................................54
REFLUX – DE SCHEPPER.......................................................................................................................54
REFLUX – KRISHNADATH......................................................................................................................63
DIARREE – DE SCHEPPER..................................................................................................................64
IBS EN CONSTIPATIE – DE SCHEPPER...............................................................................................80
IBS.................................................................................................................................................80
CONSTIPATIE.....................................................................................................................................91
IBD...................................................................................................................................................98
PATHOLOGIE – DRIESSEN.....................................................................................................................98
BEELDVORMING – OP DE BEECK.........................................................................................................105
IBD – JAUREQUI..............................................................................................................................106
DIVERTICULITIS..............................................................................................................................125
DIVERTICULAIRE AANDOENING – JAUREGUI............................................................................................125
1
,CHIRURGISCHE BENADERING VAN DIVERTICULITIS.....................................................................................134
PROCTOLOGIE................................................................................................................................136
PROCTO – DE SCHEPPER....................................................................................................................136
PROCTO – KOMEN...........................................................................................................................144
2
,SLOKDARM- EN MAAGTUMOREN
RADIOLOGIE – OP DE BEECK
Zie PP
3
, PATHOLOGIE – DRIESSEN//
In de slokdarm: vnl plaveiselcelca en adenoca voorkomen
In de maag: komt meer het adenocarcinoma voor
SLOKDARMKANKER
EPIDEMIOLOGIE VAN SLOKDARMKANKER
- Relatief frequente tumor: op de 8ste plaats wereldwijd
o Veel voorkomende doodsoorzaak (6de plaats van alle kankers)
- Komt vooral voor in de ontwikkelingslanden (80%)
o Vnl voorkomen in Azië en Afrika
- Slokdarmkanker heeft een hele slechte prognose
- Komt 2x meer bij mannen dan bij vrouwen
Slokdarmkanker bestaat uit: squameuze cel carcinomen en adenocarcinomen
Donkere zone in Azië (landkaart): Oesophageal cancer belt
In deze zone komt slokdarmkanker frequent voor en vnl het plaveiselcelca
Redenen: eerder slechte voedingstoestand, drinken van hete dranken, enzo…
België
Minder frequent (slokdarmca 16de plaats, maagkanker 13de plaats)
Frequenter voorkomen bij mannen dan bij vrouwen
TYPES VAN OESOFAGIALE KANKER: SQUAMEUZE CEL CARCINOMEN
Risicofactoren:
- Roken
- Alcohol
o In Westerse landen meer voorkomen van adenoca dan plaveiselcelcarcinoom
o Uitzondering: streek van Normandië (plaveiselcelca meer voorkomen)
- Hete dranken
- Dieet: te weinig groenten of fruit, BBQ
- Ioniserende stralen
- HPV? Minder duidelijke relatie, bij hoofdhalstumoren wel een duidelijke relatie.
Predisponerende factoren:
- Achalasie (= chronische ziekte waarbij bezenuwing v slokdarm beschadigd is)
- Laesies van de oesofagus
- Squameus cel carcinoom (plaveiselcelca) in de hoofd-hals regio 3-14% geassocieerd met squameus
cel carcinoom van de oesofagus
4
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