Synopsis
Gastrointestinal pathology stands out as a captivating field in contemporary surgical pathology, presenting a wealth of opportunities for observing and analyzing various illnesses and medical conditions. The surgical pathology of the gastrointestinal system revolves around the digestion system, the liver, and the biliary tract and its changes and illnesses. If you use high-quality digital equipment, surgical pathology of the gastrointestinal system can become a high-rewarding area for a surgical pathologist. The key role of gastrointestinal pathology is to provide services and expert diagnostic interpretation. By having specialized training and acquiring the experience needed, you can become an expert in this area. Today, we will delve deeper into the captivating field of gastrointestinal pathology.
What is Gastrointestinal Pathology?
Gastrointestinal pathology is a subspecialty discipline of surgical pathology. The specimens observed during gastrointestinal pathology include the gastrointestinal tract, liver, biliary tract, and pancreas. The service provides comprehensive diagnostic expertise for the full range of gastrointestinal/liver/pancreas diseases. It deals with diagnosing and characterizing neoplastic and non-neoplastic diseases with special emphasis on chronic inflammatory diseases and tumors in the gastrointestinal tract, pancreas, and liver.
Key Attributes in Gastrointestinal Pathology
Gastrointestinal pathology education includes specialized training in diagnostic gastrointestinal, liver, and pancreaticobiliary pathology, including the evaluation of biopsies, resection specimens, and consultation material. Several observations are made to diagnose various medical conditions during surgical pathology of the gastrointestinal system. First, the color, shape, and size of organs are examined for any abnormalities. Then the texture and thickness of the tissues are evaluated to determine the presence of any lesions or tumors. Finally, the presence of any inflammation, infection, or other anomalies is observed to establish a diagnosis and guide appropriate treatment.
Organs Under Observation
During surgical pathology, several organs of the gastrointestinal system are examined to detect abnormalities. These observations provide valuable information for diagnosing and treating diseases such as cancer, inflammatory bowel disease, and gastrointestinal bleeding. Some of the common organs observed during surgical pathology of the gastrointestinal system include:
1. Stomach
The stomach is a saccular organ located in the upper abdomen. The stomach possesses a muscular layer comprising three layers that work together to ensure the proper mixing of the ingested food into chyme. These three layers include an outer longitudinal layer, a middle circular layer, and an inner oblique layer. Cells that secrete HCI and pepsin are restricted mainly to the body and fundus regions. Gland of the cardia and pylorus produce primarily mucus. In the surgical pathology of the gastrointestinal system, the most studied diseases are developmental disorders, inflammatory disorders, and gastric neoplasms.
2. Esophagus
The esophagus is a muscular tribe that extends from about the level of the cricoid cartilage to its intersection with the stomach, known as the gastroesophageal junction. Upon observation, the longitudinal section of the esophagus reveals a mucosa composed of non-keratinized stratified squamous epithelium, lamina propria, and smooth muscles of the muscularis mucosae. Beneath the mucosa is the submucosa containing esophageal mucous glands. One of the most intriguing pathological aspects of the esophagus is the developmental abnormalities that can involve atresia, fistulae, webs, and rings. The most frequent anomaly is esophageal atresia with a distal tracheoesophageal fistula.
3. Small Intestine
Surgical pathology of the small intestine involves diverse developmental disorders and medical conditions such as Meckel diverticulum that occurs when there is a persistent remnant of a vitelline duct next to the bowel wall. This disorder exists in 2% of the population and occurs twice as common in males compared to females. Celiac disease, an autoimmune disorder, can affect both adults and children, and its occurrence seems to have a genetic basis. Peptic duodenitis, an inflammatory disease, is a continuum of peptic ulcer disease. It is characterized by acute and chronic inflammation of the duodenal mucosa. Crohn’s disease, an inflammatory bowel disease, can affect both the small and large intestines, but it is more commonly found in the terminal ileum. Adenocarcinomas are the most frequent type of tumor that develops in the small intestine, and they have a slightly higher incidence in men than in women. Therefore, the diagnosis of Crohn’s disease should include thorough evaluation and monitoring of both the small and large intestines to detect any potential tumor development, especially in high-risk populations.
4. Colon
The colon is the distal segment of the gastrointestinal tract. It begins at the ileocecal valve and continues with the ileum of the small bowel that ends with the anus. The principal diseases of the colon include developmental, inflammatory, and neoplastic disorders. These diseases can be observed and detected during surgical pathology of the colon.
5. Appendix
In the surgical pathology of the gastrointestinal system, pathologists usually analyze patients with diseases such as acute appendicitis and neoplasms. Acute appendicitis is one of the principal diseases of the appendix that surgical pathology observes. It is an acute inflammation of the wall of the appendix and it can result in abdominal pain, nausea, vomiting, fever, and leukocytosis. Usually, it affects children and adolescents. Neoplasms and neuroendocrine tumors are other medical conditions that are commonly associated with the appendix, particularly in young adults.
6. Liver
Liver pathology can be quite challenging. Every aspiring surgical pathologist who wants to specialize in an area of the liver must be familiar with some of the most common and important entities encountered in the practice of liver pathology. It is typically divided into nonneoplastic and neoplastic pathology. The practice of liver pathology is one of the disciplines that heavily relies on a multidisciplinary team that often involves hepatologists, radiologists, surgeons, and oncologists.
7. Biliary Tract
The biliary tract encompasses the complex process of bile production, storage, and secretion, which involves the liver, gallbladder, and bile ducts. This intricate system plays a crucial role in aiding digestion and removing waste products from the body. Biliary tract surgical pathology refers to diseases such as primary sclerosing cholangitis, primary biliary cirrhosis, and biliary atresia. Surgical pathology related to the biliary tract also encompasses the diagnosis and treatment of various disorders affecting this complex system, such as biliary colic, acute cholecystitis, and recurrent pyogenic cholangitis.
8. Pancreas
The pancreas is susceptible to a diverse range of diseases, including both non-neoplastic and neoplastic conditions. The surgical pathology of the pancreas often involves the diagnosis and management of various disorders, such as pseudocysts, metastatic tumors, ductal adenocarcinoma, and endocrine neoplasia. Accurate identification and prompt treatment of these conditions are crucial for ensuring optimal health outcomes.
Conclusion
Gastrointestinal pathology is an interesting area of specialization for surgical pathologists. It includes the study and analysis of the anatomy of the gastrointestinal tract, liver, biliary tract, and pancreas. Although it is a subspecialty of surgical pathology, gastrointestinal pathology is a complex field and it requires a good knowledge of the gastrointestinal system before analyzing the diseases. Each organ within the gastrointestinal tract, such as the stomach, colon, or appendix, is susceptible to developing a specific disease. The occurrence of such diseases in different locations of the gastrointestinal tract can vary widely.
