BENIGN

DISORDERS OF
STOMACH
BY

Dr.Firdosh A.Dekhaiya (M.S.)

Assistant professor,
Surgery
Govt.Medical college,Bhavnagar.
TUMOURS
EPITHELIAL POLYPS
Hyperpastic
Adenomatous

MESENCHYMAL TUMOURS
Leiomyoma
Fibroma
Neurogenic
-Schwannoma
-Neurofibroma
Lipoma
Vascular
Osteroma and Osteochondroma

MISCELLANEOUS TUMOURS
Heterotopic pancreas
Inflammatory pseudotumours
Hemartomatous in Peutz-Jeghers polyp
Cyst
Benign tumours of stomach are RARE and
found incidentally on endoscopically or in
postmortem examination.

Occassionally they present as

pain,bleeding,or gastric outlet obstruction.

The only cause of concern is that some of

them have POTENTIAL FOR MALIGNANT
TRANSFORMATION.

Majority of them are EPITHELIAL

TUMOURS(75%).
 HYPERPLASTIC POLYPS

 Distributed throughout stomach

 Multiple
 <2 cm in diameter.
 5 times as commoon as adenomatous.
 May undergo spontaneous regression.
 No potential for malignancy
 ADENOMATOUS POLYPS

 Most commonly seen in antrum

 Usually SINGLE.
 >2 cm diameter usually.
 When so,nearly 33-50% of these tumours
will become malignant.
 MESENCHYMAL TUMOURS

 1/8th of all gastric neoplasms

 Leiomyomas are commonest.

 All variety are very similar in appearance

and behaviour,hence described together.
 MESENCHYMAL TUMOURS
 Usually single
 Located in submucosa.
 Rounded sessile or pedunculated masses
 Ulceration with bleeding commonly seen.
 Size varies from a few mm to many cms.
 Location:antrum
 Leiomyomas and fibromas can also be
found near gastro oesophageal junction.
 MESENCHYMAL TUMOURS
 Degeneration:
-cystic changes
-myxoid degeneration
-calcification
-ossification
 Malignant transformation occurs in
vascular and untreated tumours.
 MESENCHYMAL TUMOURS
PRESENTING SYMPTOMS
 Mostly asymptomatic but may present as:
 Malena
 Anemia
 Dyspepsia
 Gastric outlet obstruction (due to
prolapsed growth through pylorus)
 In elderly-palpable abdominal mass
 HETEROTOPIC PANCREAS
 Usually found in antrum or prepyloric
region.
 Discrete,rubbery lesions,upto 3 cm dia.
 May have umbilicated appearance(a
central ductal orifice).
 All pancreatic pathologies affect them.
INFLAMMATORY PSEUDOTUMOURS

Also known as-

 Inflammatory fibroid polyps

 Eosinophilic granulomas
 Eosinophilic gastritis
 Gastric submucosal granulomas with
eosinophilic infiltration
INFLAMMATORY PSEUDOTUMOURS

 Present as polypoidal or infiltrative lesions

 Many cms large
 Mostly ulcerated.
 Histology:inflammation with connective
tissue and vascular proliferation with
predominantly eosinophilic cell infiltrate.
 Mimic malignancy.
 PEUTZ-JEGHER’S POLYPS
 These are monmalignant malformations
or hemartomas that represent focal
overgrowth,and may be found
occassionally in the stomach.

 Whether they are precancerous or not is

not known.
 CYSTIC TUMOURS

 Very rare.

 A heterogenous group of developmental

anomalies,infective,posttraumatic or
neoplastic lesions.
MENETRIER’S DISEASE
(Hypertrophic gastritis)
 MENETRIER’S DISEASE
(Hypertrophic gastritis)
 A rare inflammatory disease of the gastric
epithelium characterized by hypertrophic
gastric folds within the proximal stomach.

 Later the epithelium assumes the

appearance of large,multiple,polypoid
overgrowths.
 MENETRIER’S DISEASE
(Hypertrophic gastritis)

 Histology:Thickened folds consist of

hypertrophy of the gastric glandular
epithelium+increase in size of
submucosa,which is oedematous and
contains a large no. of round cells(Hence a
hypothesis of autoimmune aetiology).
 MENETRIER’S DISEASE
(Hypertrophic gastritis)

 Clinically :massive loss of plasma proteins

from gastric epithelium that is normally
impermeable to large molecules.
 BEZOARS

13/08/2009 13/08/2009
 BEZOARS
 Bezoars are concretions of indigestible
matter that accumulates in the stomach.
 Examples:
-Trichobezoars
-Phytobezoars
-Pharmacobezoars
 DIEULAFOY’S LESION
 A gastric arterial venous malformation
that has a characteristic histological
appearance.
 When not bleeding,this lesion may be
invisible.
 When bleeds it appears as profuse
bleeding coming out from normal mucosa.
 GASTRIC DIVERTICULA
 Rare lesions.
 Consist of all 3 layers
 Usually congenital.
 Common age of presentation:20-60
 Common site: Posterior cardia and body
 Complications:rare but haemorrhage and
infection can occur.
 MALLORY-WEISS TEARS
 Lacerations in the region of G-E junction
that can follow episodes of vomitting &
retching.
 Often associated with heavy alcohol
consumption and may produce excessive
GI bleeding.
 Self limiting in 80-90% of pts.
 GASTRIC VOLVULUS
 Torsion or twist
 Typically occurs along the long axis of the
stomach(organoaxial) in association with
paraoesophageal hernias so that in contrast
studies stomach appears upside down.
 Presents as sudden severe epigastric pain
and unability to vomit,and it is unable to
pass a Ryle’s tube.
FOREIGN BODIES