A 42 year old male complains of abdominal pain that began approximately 6 months earlier. The pain is constant in nature, especially after meals, and is located in the epigastric region. He also reports some heartburn that occurred during the previous year. He announces that he has been under significant job-related stress and has been self-medicating himself with antacids, which provided some relief. Recently, he observed that his stools have changed in colour and consistency, with intermittent passing of dark, tar-like stools. The submitted stool sample indicates the presence of blood, and was positive for Helicobactor pylori antigens. Each question has marks allocated – total of 10 marks.
Q1. What is the likely diagnosis?
Q2. Name ALL the layers of the affected organ from the lumen out, and indicate which cells are most likely to have the h.pylori infection.
Q3. Why do the antacids provide the patient with relief from pain? You answer should include the normal functions of the infected cells within the organ, and provide a brief pathogenesis of the h.pylori.
Q4. An endoscopy reveals the fundus as the affected location of the organ. Surgical intervention is required to treat the condition, and the surgeon elects to perform a partial gastrectomy. Outline the path of blood flow (including relevant branches) to this region of the organ, starting from the abdominal aorta. In your answer, indicate which arteries would need to be clamped to perform the surgery.