Gastroenterology Volume I Second Edition【2025|PDF下载-Epub版本|mobi电子书|kindle百度云盘下载】

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SECTION Ⅰ THE EXAMINATION OF THE PATIENT1

Chapter 1 HISTORY TAKING＆J．L．A．ROTH3

INTRODUCTION3

RECORDING THE HISTORY4

HISTORY OF PRESENT ILLNESS4

PAST MEDICAL HISTORY6

PERSONAL HISTORY8

FAMILY HISTORY13

Chapter 2 SYMPTOMATOLOGY14

ABDOMINAL PAIN AND DISCOMFORT14

Philosophic Concepts—Beneficent vs．Deleterious Effect of Pain15

Appraisal of Pain Intensity16

Mechanism of Abdominal Pain18

Pitfalls in the Interpretation of Abdominal Pain26

Clinical Appraisal of Pain28

Chapter 3 SYMPTOMATOLOGY(Continued)＆J．L．A．ROTH37

DISAGREEABLE TASTE38

COATED TONGUE38

SORE TONGUE39

BAD BREATH39

HUNGER AND APPETITE40

THIRST44

NAUSEA44

VOMITING45

REGURGITATION50

RUMINATION51

HICCUP51

PYROSIS52

DYSPHAGIA54

AEROPHAGIA59

HEADACHE AND THE GASTROINTESTINAL TRACT69

VERTIGO69

OTHER SYMPTOMS70

Chapter 4 PHYSICAL EXAMINATION72

GENERAL INSPECTION73

LYMPH NODES75

NERVOUS SYSTEM76

HEAD AND NECK76

CHEST AND CARDIOVASCULAR SYSTEM78

EXAMINATION OF ABDOMEN78

Inspection78

Palpation and Percussion80

Auscultation89

EXAMINATION OF SPINE89

RECTAL EXAMINATION90

EXAMINATION OF THE PELVIS AND GENITALS91

Chapter 5 ORAL MANIFESTATIONS OF INTERNAL DISEASE＆LESTER W．B？RKET93

GINGIVITIS94

GINGIVAL ENLARGEMENT94

ULCERONECROTIC GINGIVOSTOMATITIS(TRENCH MOUTH)95

THE METALLIC STOMATITIDES96

HERPETIC STOMATITIS96

ERYTHEMA MULTIFORME97

HYPERKERATOTIC LESIONS OF THE ORAL MUCOSA98

MONILIASIS100

ORAL ASPECTS OF NUTRITIONAL DEFICIENCIES101

DISEASES OF THE TONGUE103

Chapter 6 THE MANNER OF UTILIZING THE LABORATORY AND OTHER METHODS IN DIAGNOSIS107

CHOICE OF DIAGNOSTIC AIDS107

GENERAL PRINCIPLES IN THE DIAGNOSTIC SURVEY108

SECTION Ⅱ THE ESOPHAGUS AND DIAPHRAGM311

Chapter 7 APPLIED ANATOMY AND PHYSIOLOGY OF THE ESOPHAGUS＆FRANK BROOKS113

ANATOMY113

PHYSIOLOGY119

Chapter 8 ANOMALIES AND THE ESOPHAGUS，ESOPHAGEAL STENOSIS AND STRICTURE124

ANOMALIES124

ESOPHAGEAL STENOSIS OR STRICTURE(NOT CONGENITAL)＆Joseph P．Atkins127

Caustic Burns and Stricture128

Roentgenolic Diagnosis＆L．S．Finkelstein129

Treatment＆Joseph P．Atkins130

Chapter 9 TESTS EMPLOYED IN THE STUDY OF ESOPHAGEAL FUNCTION AND DISEASE132

INTRODUCTION132

ESOPHAGOSCOPY IN THE STUDY OF ESOPHAGEAL AFFECTIONS＆Joseph P．Atkins133

MEDICAL ESOPHAGOSCOPY＆B．H．Sullivan，Jr138

EXFOLIATIVE CYTOLOGY OF THE ESOPHAGUS＆F．Vilardell141

Chapter 10 ACHALASIA(CARDIOSPASM)＆J．L．A．ROTH145

DEFINITION145

ETIOLOGY—PATHOGENESIS146

DIAGNOSIS AND DIFFERENTIAL DIAGNOSIS154

Esophagoscopy in Diagnosis＆Joseph P．Atkins157

Roentgenologic Diagnosis＆George N．Stein158

COMPLICATIONS AND ASSOCIATED DISEASES161

THERAPY163

Endo-esophageal Treatment—Dilatation＆Joseph P．Atkins164

Surgical Treatment＆Herbert R．Hawthorne and Paul Nemir，Jr165

PROGNOSIS166

Chapter 11 TUMORS OF THE ESOPHAGUS＆JAMES F．YOUNG169

CARCINOMA OF THE ESOPHAGUS169

Pathology170

Diagnosis171

X-ray Examination＆L．S．Finkelstein172

Exfoliative Cytology＆F．Vilardell177

Complications178

Therapy178

Radiation Therapy＆E．A．Tulsky179

OTHER MALIGNANT TUMORS182

BENIGN TUMORS OF THE ESOPHAGUS182

X-ray Diagnosis＆L．S．Finkelstein183

Chapter 12 ESOPHAGEAL DIVERTICULUM＆JOHN H．WILLARD186

PHARYNGEAL(PHARYNGO-ESOPHAGEAL)DIVERTICULUM186

X-ray Diagnosis＆L．S．Finkelstein189

TRACTION DIVERTICULUM191

TRACTION-PULSION DIVERTICULUM193

Chapter 13 Part Ⅰ—ESOPHAGITIS AND PEPTIC ULCER OF THE ESOPHAGUS＆J．L．A．ROTH195

ESOPHAGITIS AND PEPTIC ULCER OF THE ESOPHAGUS195

Etiology196

Pathogenesis of Reflux Esophagitis197

Pathogenesis and Classification of Peptic Ulcer of the Esophagus198

Pathology200

Clinical Features201

Esophagitis201

Diagnosis and Differential Diagnosis201

X-ray Diagnosis＆L．S．Finkelstein202

Peptic Ulcer of Esophagus206

Diagnosis207

Therapy208

Part Ⅱ—TUBERCULOSIS，SYPHILIS，FUNGUS INFECTION AND SCLERODERMA OF THE ESOPHAGUS210

TUBERCULOSIS210

SYPHILIS211

FUNGUS INVOLVEMENT213

SCLERODERMA213

Chapter 14 DYSPHAGIA WITH IRON DEFICIENCY，ESOPHAGEAL WEBS AND ESOPHAGEAL RINGS＆FRANZ GOLDSTEIN216

DYSPHAGIA WITH IRON DEFICIENCY(PLUMMER-VINSON SYNDROME，PATERSON-KELLY SYNDROME)216

Diagnosis217

X-ray＆L．S．Finkelstein and F．Goldstein217

LOWER ESOPHAGEAL WEBS219

LOWER ESOPHAGEAL RINGS(SCHATZKI＇S RINGS)219

Chapter 15 VARICES，FOREIGN BODIES，FISTULA AND PERFORATION OF ESOPHAGUS＆JOSEPH P．ATKINS223

ESOPHAGEAL VARICES223

Diagnosis223

X-ray＆L．S．Finkelstein224

FOREIGN BODIES IN THE ESOPHAGUS225

Diagnosis226

X-ray＆L．S．Finkelstein227

Treatment228

ESOPHAGEAL FISTULA228

Roentgenologic Diagnosis＆L．S．Finkelstein229

PERFORATION AND RUPTURE OF THE ESOPHAGUS229

Chapter 16 DIAPHRAGMATIC HERNIA，ESOPHAGEAL HIATUS HERNIA AND EVENTRATION OF THE DIAPHRAGM232

DIAPHRAGMATIC HERNIA233

ESOPHAGEAL DIAPHRAGMATIC HIATUS HERNIA235

When to Suspect Hiatus Hernia—Significant Clinical Features239

Gastric Analysis241

Einhorn String Test241

X-ray Examination＆G．N．Stein and A．Finkelstein242

Esophagoscopy246

Concomitants of Hiatus Hernia and the Differential Diagnosis247

Complications251

Therapy254

Surgical Management of Hiatus Hernia＆Herbert R．Hawthorne256

Prognosis257

EVENTRATION OF THE DIAPHRAGM257

SECTION Ⅲ AFFECTIONS OF THE STOMACH263

Chapter 17 APPLIED ANATOMY AND PHYSIOLOGY OF THE STOMACH＆ALVIN J．CUMMINS265

APPLIED ANATOMY OF THE STOMACH266

FUNCTIONS OF THE STOMACH275

Secretory Function276

Motor Functions of the Stomach283

Chapter 18 TESTS EMPLOYED IN THE STUDY OF GASTRIC FUNCTION AND DISEASE：ANALYSIS OF THE STOMACH CONTENTS＆DAVID C．H．SUN289

EXAMINATION OF GASTRIC CONTENTS290

Gastric Residuum290

Chemical Examination of Gastric Content296

Cultures of Stomach Content298

Fractional Gastric Analysis(Rehfuss)299

CAFFEINE GASTRIC ANALYSIS304

TEST FOR BASAL GASTRIC SECRETION(INTERDIGESTIVE)305

HISTAMINE TEXT FOR GASTRIC SECRETORY FUNCTION307

INSULIN HYPOGLYCEMIA GASTRIC ANALYSIS FOR EVALUATING VAGAL CONTINUITY310

PEPSINOGEN IN THE BLOOD311

PEPSINOGEN IN THE URINE(UROPEPSIN )312

GASTRIC ANALYSIS WITH ALCOHOL TEST MEAL312

TUBELESS GASTRIC ANALYSIS313

NEUTRAL RED TEST FOR GASTRIC SECRETORY FUNCTION314

Chapter 19 OTHER AIDS IN THE STUDY OF GASTRIC FUNCTION AND DISEASE317

FLUOROSCOPY AND ROENTGENOGRAPHY317

GASTROSCOPY＆J．F．Monaghan and P．R．Nast318

EXFOLIATIVE CYTOLOGY＆F．Vilardell329

EINHORN STRING OR THREAD IMPREGNATION TEST337

Fluorescein String Test in Hemorrhage339

Chapter 20 DISORDERS OF GASTRIC SECRETION＆DAVID C．H．SUN340

ACHLORHYDRIA，ANACIDITY AND ACHYLIA340

GASTRIC HYPERACIDITY347

GASTRIC HYPERSECRETION348

Chapter 21 ACUTE GASTRITIS＆ARTHUR M．SCHOEN351

ACUTE EXOGENOUS GASTRITIS351

ACUTE ENDOGENOUS GASTRITIS360

Chapter 22 CHRONIC GASTRITIS＆F．VILARDELL368

HISTORICAL ASPECTS369

PATHOLOGY AND CLASSIFICATION370

ETIOLOGY373

DIAGNOSTIC PROCEDURES377

Gastric Suction Biopsy381

Gastroscopy＆J．F．Monaghan and P．R．Nast385

Biopsy-Gastroscopy Correlations390

Gastric Secretions and Chronic Gastritis392

Radiology of Gastritis396

DIAGNOSIS OF GASTRITIS399

THERAPY400

Chapter 23 CHRONIC GASTRITIS(Continued)Special Types．Its Relation to Other Diseases＆F．VILARDELL405

POSTANASTOMOTIC GASTRITIS405

GIANT HYPERTROPHY OF THE GASTRIC MUCOSA(MENETRIER＇S DISEASE)406

FOCAL LYMPHODD HYPERPLASIA OF THE GASTRIC MUCOSA412

GASTRITIS AND PEPTIC ULCER413

CHRONIC GASTRITIS AND CANCER414

GASTRITIS AND ANEMIA415

Chapter 24 ETIOLOGY AND PATHOLOGY OF GASTRIC AND DUODENAL ULCER＆HARRY SHAY and DAVID C．H．SUN420

ETIOLOGY OF PEPTIC ULCER421

Definition—Introduction421

Mucosal Defensive Factors422

Aggressive Factors425

Acid-Pepsin425

Adrenal Gland and Peptic Ulcer427

Stress and Gastric Secretion．Hypothalamico-Pituitary-Adrenal Concept430

The Brain and Autonomic Nervous System in Peptic Ulcer433

Stressful Stimuli Other Than Purely Emotional Stress435

Psychosomatic Relationships436

Pituitary Gland438

Sex Hormones439

Thyroid and Parathyroid Glands439

Pancreas440

Allergy442

Infection and Peptic Ulcer443

Relation of Reserpine，Phenylbutazone，Aspirin，Nicotine and Caffeine to Peptic Ulcer444

Heredity and Constitution in Peptic Ulcer446

Gastric and Duodenal Ulcers Fundamentally Different？449

PATHOLOGIC ANATOMY OF PEPTIC ULCER451

Chapter 25 DIAGNOSIS OF UNCOMPLICATED CHRONIC PEPTIC ULCER466

FREQUENCY AND ECONOMIC IMPORTANCE467

SUBJECTIVE COMPLAINTS469

Mechanism of Ulcer Pain469

Peptic Ulcer Syndrome472

PHYSICAL EXAMINATION479

X-RAY DIAGNOSIS OF GASTRIC ULCER＆G．Stein482

X-RAY DIAGNOSIS OF DUODENAL ULCER491

GASTROSCOPY IN DIAGNOSIS OF GASTRIC ULCER＆J．F．Monaghan and P．R．Nast497

GASTRIC ANALYSIS AND CYTOLOGIC EXAMINATION499

BLOOD IN THE STOOLS503

BLOOD COUNT503

BLOOD GROUPS AND PEPTIC ULCER505

STRING TEST OF EINHORN505

ENDOCRINE TUMORS AND PEPTIC ULCER505

DIAGNOSTIC SUMMARY AND DIFFERENTIAL DIAGNOSIS506

ULCER-CANCER RELATIONSHIP507

Malignant Change in Gastric Ulcer507

Differential Diagnosis Between Benign and Malignant Gastric Ulcer509

Roentgenologic Classification of Ulcerating Gastric Lesions＆G．Stein and A．Finkelstein517

Gastric Analysis and Cytologic Examination519

Other Laboratory Findings519

In vivo Radioautography519

Trial of Therapy519

Independent Occurrence of Ulcer and Cancer in the Same Stomach520

PYLORODUODENAL IRRITABILITY(PSEUDO-ULCER SYNDROME)(IRRITABLE DUODENUM)(EFFECT OF TOBACCO)(HYPERINSULINISM)521

Chapter 26 MANAGEMENT OF UNCOMPLICATED PEPTIC ULCER527

IMPORTANCE OF COMPLETE DIAGNOSIS IN ORGANIZATION OF THERAPEUTIC REGIMEN528

Adequate History528

Complete Diagnosis529

HEALING THE PRESENT ULCER，TREATMENT DIRECTED TOWARD ACTIVE ULCER AND ITS IMMEDIATE ENVIRONMENT534

Principles of Physiologic Stomach Rest534

Diet535

Antacids538

Antisecretory and Motor Inhibitor(Anticholinergic)Drugs547

Sedatives549

Avoidance of Gastric Irritants and Stimulants550

Control of Night Distress550

Drugs to Increase Mucosal Resistance and Miscellany551

Hospitalization Versus Ambulatory Treatment552

Duration of Active Ulcer Regimen552

Special Therapeutic Measures in Ulcer Therapy553

Ritual for Gastric Ulcer556

Prevention and Management of Iatrogenic Peptic Ulcer556

Ulcer Cure or Prevention of Recurrence557

DIET AND THERAPY OUTLINES FOR PATIENTS WITH PEPTIC ULCER559

Chapter 27 COMPLICATIONS OF PEPTIC ULCER DISEASE＆WILLIAM S．HAUBRICH565

VARIETIES AND VAGARIES OF PERFORATION566

ACUTE FREE PERFORATION568

ACUTE PERFORATION WITH SPONTANEOUS CLOSURE582

PENETRATION AND CONFINED PERFORATION582

OBSTRUCTION AT OR NEAR THE PYLORUS592

BILOCULAR STOMACH602

SUBPHRENIC ABSCESS605

CARCINOMA AT SITE OF DUODENAL ULCER609

Chapter 28 HEMATEMESIS AND MELENA＆A．BOGOCH614

INTRODUCTION AND CLASSIFICATION OF CAUSES616

CAUSES OF HEMATEMESIS AND MELENA617

Sources of Bleeding618

Diseases of the Esophagus618

Diseases of the Stomach and Duodenum621

Diseases of the Small Intestine629

Diseases of Proximal Colon630

Diseases of Neighboring Organs630

Diseases of Blood632

Diseases of Blood Vessels636

Systemic Diseases638

CLINICAL AND PHYSIOLOGIC EFFECTS OF MASSIVE GASTRODUODENAL BLEEDING640

EARLY DIAGNOSTIC INVESTIGATIONS648

MEDICAL MANAGEMENT653

MORTALITY IN BLEEDING PEPTIC ULCER；SELECTION OF PATIENTS FOR EMERGENCY SURGERY659

FOLLOW-UP DIAGNOSTIC STUDIES AND MANAGEMENT663

ELECTIVE SURGERY FOR PREVENTION OF RECURRENT BLEEDING663

Chapter 29 INDICATIONS FOR OPERATION AND SELECTION OF OPERATIVE PROCEDURE IN THE MANAGEMENT OF PEPTIC ULCER DISEASE＆J．L．A．ROTH668

INDICATIONS FOR OPERATION668

Operation for Complications669

Operation for Intractability671

Operation for Gastric Ulcer672

INDIVIDUALIZED SELECTION OF ULCER OPERATION674

Chapter 30 CARE OF THE SURGICAL PATIENT＆DONALD R．COOPER682

EXPECTED RESPONSE OF A NORMAL PATIENT TO SURGICAL TRAUMA683

PREOPERATIVE PREPARATION685

POSTOPERATIVE PERIOD696

Chapter 31 SEQUELAE OF GASTRIC SURGERY FOR PEPTIC ULCER＆WILLIAM S．HAUBRICH702

EARLY POSTGASTRECTOMY PROBLEMS703

INTERMEDIATE POSTGASTRECTOMY PROBLEMS705

LATER POSTGASTRECTOMY PROBLEMS707

Recurrent Peptic Ulceration707

Postprandial Problems714

Nutritional Impairment720

OTHER POSTGASTRECTOMY PROBLEMS725

Return to Gainful Endeavor727

PREVENTION OF POSTGASTRECTOMY PROBLEMS727

Chapter 32 FACTORS INFLUENCING PROGNOSIS IN PEPTIC ULCER734

Age734

PAST MEDICAL HISTORY735

CHARACTER OF ULCER736

ULCER ENVIRONMENT OR LOCAL MILIEU(EXCLUDING COMPLICATIONS)737

INFLUENCE OF ASSOCIATED DISEASE738

IMMEDIATE INFLUENCE OF COMPLICATIONS739

INTRACTABILITY741

Chapter 33 CARCINOMA OF THE STOMACH743

FREQUENCY745

PATHOGENESIS746

PATHOLOGY749

DIAGNOSIS755

Symptomatology755

Physical Examination759

X-ray Examination760

Gastroscopy＆J．F．Monaghan and P．R．Nast767

Gastric Cytology＆F．Vilardell771

Gastric Analysis775

Examination of Stools777

Blood Picture777

Blood Chemistry，Serology and Sedimentation777

Gastrocamera777

Radioactive Phosphorus778

Electrogastrogram779

Final Remarks on Diagnosis779

DIFFERENTIAL DIAGNOSIS780

COMPLICATIONS784

TREATMENT785

Prophylaxis785

Surgical Treatment＆L．Kraer Ferguson786

Radiation Therapy795

Other Therapeutic Agents795

Medical Care795

PROGNOSIS796

Chapter 34 MALIGNANT TUMOBS OF THE STOMACH OTHER THAN CARCINOMA＆J．F．YOUNG802

MALIGNANT LYMPHOMAS802

Classification and Pathology802

Incidence803

Clinical Features804

X-ray Study805

Gastroscopy＆J．F．Monaghan and P．R．Nast806

Cytologic Aspects＆F．Vilardell807

Other Diagnostic Aids809

Therapy809

Surgical Management809

Radiation and Chemotherapy＆E．G．Tulsky809

Prognosis810

LEUKEMIA810

SMOOTH MUSCLE TUMORS811

Leiomyosarcoma811

OTHER SARCOMAS813

CARCINOIDS(ARGENTAFFINOMAS)813

METASTATIC DISEASE INVOLVING THE STOMACH814

Chapter 35 BENIGN TUMORS OF THE STOMACH＆V．TACHDJIAN817

INCIDENCE817

ETIOLOGY AND PATHOLOGY818

TYPES OF TUMOR AND HISTOLOGIC FEATURES818

CLINICAL FEATURES828

X-RAY EXAMINATION829

ENDOSCOPY＆J．F．Monaghan and P．R．Nast831

DIAGNOSIS832

TREATMENT AND PROGNOSIS832

Chapter 36 CHRONIC INFECTIONS OF THE STOMACH，GRANULOMAS OF THE STOMACH AND DUODENUM，FOREIGN BODIES835

SYPHILIS AND THE STOMACH836

Syphilis of the Stomach836

Gastric Manifestations of Extragastric Syphilis850

Gastric Crises of Cerebrospinal Syphilis851

Treatment＆A．Tornay854

OTHER CHRONIC INFECTIONS＆Geraldo Siffert857

Tuberculosis of the Stomach857

Treatment，＆D．D．Harrell861

Mycotic Infections of the Stomach861

Anthrax of the Stomach862

GRANULOMAS OF THE STOMACH AND DUODENUM864

Eosinophilic Granuloma864

Granuloma Related to Regional Enteritis865

FOREIGN BODIES IN THE STOMACH869

Chapter 37 PYLORIC MUSCLE HYPERTROPHY IN ADULTS．PROLAPSE OF GASTRIC MUCOSA THROUGH THE PYLORUS＆J．EDWARD BERK875

PYLORIC MUSCLE HYPERTROPHY IN ADULTS875

PROLAPSE OF GASTRIC MUCOSA THROUGH THE PYLORUS886

Chapter 38 DIVERTICULA OF THE STOMACH＆JOHN H．WILLARD893

CLINICAL FEATURES895

TREATMENT897

Chapter 39 ANOMALIES OF THE STOMACH＆ORVILLE F．NIELSEN899

CONGENITAL HYPERTROPHIC PYLORIC STENOSIS901

CASCADE STOMACH905

PREPYLORIC SEPTUM909

CONGENITAL DEFECT OF GASTRIC MUSCULATURE910

VOLVULUS OF THE STOMACH911

DUPLICATION OF THE ALIMENTARY TRACT914

Chapter 40 ACUTE DILATATION OF THE STOMACH AND INJURIES AND RUPTURE OF THE STOMACH＆ORVILLE F．NIELSEN920

ACUTE DILATATION OF THE STOMACH920

INJURIES AND RUPTURE OF THE STOMACH925

INDEX929