Where is the prepyloric section of the stomach located?

February 11, 2021

The stages of stomach cancer are not just a ranking of the disease according to its distribution in the body, providing for certain treatment tactics, it is even more than a prognosis for the future. The stage changes the entire life of the patient and his family, defining a new model of life.

Meanwhile, cancer detected at an early stage of development is a chronic disease that gives a person decades of life. Every second patient who survives treatment for early gastric cancer will die from cardiovascular disease without any signs of a malignant process.

Stomach cancer stage 1

The first stage is early cancer, when the tumor has not violated the boundaries of the mucous membrane, but its length can be several centimeters, the main thing is that the cancer cells have not spread into the depths of the gastric wall.

Possible distribution options:

• The neoplasm is very tiny - exclusively within the mucous membrane, this is subgroup “A” of the first stage, or IA for short;
• The neoplasm is just as tiny, but there are already metastases in one or two lymph nodes - subgroup “B” of the first stage, or IB for short;
• The neoplasm spreads to the underlying layers of the mucous membrane, but the lymph nodes are free of cancer cells - also IB.

The operation allows almost 95% of patients to continue living without any fears and, importantly, in most cases there is no need for postoperative preventive chemotherapy.

Pyloric section of the stomach: where it is located and how it is structured, functions, typical diseases

Despite the simplicity of the anatomical structure, the stomach has several functional sections. Moving from department to department, the food bolus is ground, after which it enters the duodenum and large intestine. One of these segments is the pyloric section of the stomach, which performs not only a digestive function.

Features and anatomical characteristics

The pylorus or pylorus is conventionally the lower part of the stomach. From below, the pyloric section is connected to the duodenum by the pyloric sphincter or sphincter - a ring-shaped muscular septum, which is responsible for the entry of the semi-digested food bolus into the sections of the small intestine ahead of time.

In addition, the pyloric sphincter allows the required volume of gastric juice to pass through and separates solid food from semi-liquid food.

In its shape, the pyloric part of the gastric cavity resembles an expanded oval, which tapers towards the duodenum. Anatomy may vary slightly, repeating the individual physiological parameters of the human body. The pyloric section is otherwise called the bottom of the stomach, which is responsible not only for the digestive, but also for a number of other functions:

• accumulation, processing and further transport of the food bolus to the lower parts of the digestive system;
• processing the food bolus with special digestive enzymes (chymosin, lipase, pepsin) and hydrochloric acid;
• production of Castle factor - a special component that absorbs, combines and transports vitamin B12 throughout the body;
• absorption of certain types of salt compounds, glucose and water:
• the production of hormones responsible for the functionality of the entire digestive system.

An important aspect in the functional purpose of the pyloric part of the stomach is the compensatory possibility in case of chronic renal failure or severe intoxication. At the moment of pronounced dysfunction of these organs, the secretion and excretion of special enzymes begins in the pyloric region, responsible for the expulsion of toxins from the blood plasma.

Regulation of the release and distribution of hydrochloric acid contributes to the antibacterial treatment of the food bolus, killing conditionally active pathogenic microflora. In addition to digestive hormones, the pyloric segment of the stomach produces serotonin, gastrin, somatostatin, and endorphins. The pyloric glands are responsible for the endocrine function of the organ and influence metabolic processes in the body.

Pathologies of the pyloric part of the stomach

Diseases of the pyloric region of the stomach are always difficult to tolerate, since the transport of the food bolus through the gastrointestinal tract is greatly impaired. Stagnation, accompanying processes of putrefaction and large secretion of gastric juice often provoke the following pathological conditions with a tendency to rapidly become chronic:

Ulcerative-erosive lesion

Ulcerative lesions of the stomach in the photo look like erosions. The main causes of the pathology are non-compliance with the rules of a normal healthy diet, infection by Helicobacter pylori, bad habits, in particular, alcohol abuse.

Regular aggressive effects on the mucous membranes provoke thinning of the mucous epithelium, up to perforation processes, perforation with multiple infectious consequences. The main symptoms of the pathology are:

• the appearance of night hunger pains;
• traces of blood in stool;
• pain when eating and after during active digestive processes;
• weight loss;
• vomiting, nausea;
• development of iron deficiency anemia;
• tarry unstable stool.

Perforation and perforation are the main complications of the ulcerative process. Without timely surgical care, the risks of death due to acute peritonitis and a generalized inflammatory process increase.

Pyloric narrowing or stenosis

Narrowing of the sphincteral sections of the pylorus or pyloric stenosis is a complicated course of peptic ulcer disease. Pathology can also be caused by the anatomical features of the gastric sections.

The mechanism of development of stenosis is the formation of a peptic ulcer followed by scarring of the functioning mucous tissue.

Symptoms are expressed in proportion to the dysfunction of the pylorus and are manifested by the following clinical manifestations:

• increased gas formation;
• flatulence;
• constipation, painful bowel movements;
• putrid belching and bad breath;
• nausea, vomiting;
• signs of chronic intoxication.

Stenosis can only be treated surgically. For pyloric stenosis, endoscopic or laparotomy surgery is performed. During the manipulation, scar tissue is excised, leading to a narrowing of the lumen of the sphincter of the lower stomach.

Oncological transformation of cells

The risks of stomach cancer are caused by polypous foci, regular active inflammatory processes, complicated by peptic ulcer disease and erosive lesions of the mucosa. Regular use of medications, as well as their inadequate use, bypassing medical prescriptions.

An important role in the malignancy of tumor cells is played by hereditary burden. If close relatives have a history of stomach cancer, the risk of cancer increases significantly. The main symptoms of oncology are:

• severe pain of unclear localization in the epigastrium, epigastric region;
• feeling of stagnation of the food bolus;
• putrefactive decomposition of food during stagnation;
• vomiting, nausea;
• general malaise;
• sudden weight loss;
• intragastric bleeding.

A common cause of precancer is the appearance of a parietal polypous lesion in the fundus of the stomach. Malignancy of a polyp under the influence of multiple factors often causes malignancy of tumor cells.

Typically, precancer includes chronic ulcerative gastritis with a high risk of perforation and perforation of the stomach walls. When the first symptoms appear, it is important to immediately consult a doctor.

Damage to the gastric parts of the stomach, including the pyloric one, can be caused by trauma (ruptures after a severe bruise, as a result of a fracture of the chest), chemical burn (accidental ingestion of alkali, poisons, household solutions), severe inflammatory process inside the body, chronic dysbiosis after poisoning, antibiotic therapy .

What the structure of the stomach looks like is described in this video.

Preventive actions

The main prevention of inflammatory diseases comes down to following a general protective regime, as well as following a special diet for the entire period of remission between exacerbations.

There is no other specific prevention against diseases of the pyloric stomach, but the following measures will help reduce the risk of developing pathologies:

• maintaining a healthy lifestyle;
• exclusion of tobacco, alcohol;
• timely response to the appearance of any atypical symptoms;
• use of medications only as prescribed by a doctor;
• compliance with the protective regime during exacerbation of chronic pathologies;
• therapeutic diet for exacerbation or severe inflammatory diseases;
• reducing the stress load on the body.

Regular disruptions in the function of the digestive system over the years lead to chronic diseases. The lack of adequate timely assistance often becomes the cause of pathology, even life-threatening conditions. Advanced gastric pathologies are usually eliminated surgically.

The prognosis for the disease depends on the severity of the pathological process, timely diagnosis and spread of inflammatory foci.

Source: https://GastrituNet.online/bolezni-zheludka/stroenie/anatomiya/otdely/piloricheskij-otdel-zheludka.html

Stomach cancer stage 2

Russian oncology statistics take into account patients of stages I and II together, and in fact this is every third newly diagnosed patient. Only in the second stage only 75% of patients survive the five-year period safely, and not more than 90% as in the first.

At this stage of the disease, most patients undergo a major, but not extensive, operation - resection in various modifications, that is, removal of part of the organ along with the lymph nodes; some will require complete removal - gastrectomy.

Our expert in this field:

Sergeev Pyotr Sergeevich

Deputy chief physician for medical work, oncologist, surgeon, chemotherapist, doctor of the highest category, Ph.D.

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The second stage is also divided into A and B. The size of the primary tumor, denoted by the letter “T,” can be different, it is possible to extend beyond the serous membrane of the stomach, but without spreading to other organs.

Damage to lymph nodes by metastases and a number from “0” to seven or more is allowed, which is indicated by the letter “N” with a number. The main thing is that the disease at this level of spread is operable.

The principle of assignment to the second stage is simple - the higher the “T” level, the lower the “N” should be:

• at T4a only N0 is possible;
• at T1 N2 and N3 are allowed;
• at T2 only N1 or N2;
• at T3 exclusively N0 or N1.

The stage of a malignant process is not just a number for statistics; a correctly established degree of spread guarantees the choice of the optimal treatment program for the disease. Correct staging of a neoplasm allows a high-quality examination, which is impossible without a professional approach and personal experience of a specialist.

The structure and functions of the gatekeeper

Compared to the body of the stomach, the size of the pyloric region is quite small, its length ranges from 4 to 6 centimeters. In some sources, this part of the organ is called the outlet to the pylorus. It has a funnel shape, gradually tapering downwards.

Some experts classify the entire lower third of the stomach, located anterior to the straight line drawn along the minor bend, as the pyloric section.

The pyloric region is tightly fixed in place, supported by the hepatogastric and hepatoduodenal ligaments. On the side of the large bend, a noticeable concavity runs along the surface of the stomach along this part of it; on the side of the small bend, there is a convexity, which is not always clearly visible. They can be detected on an x-ray of an organ filled with a contrast agent, and they are more noticeable on an atonic stomach with poorly developed muscles than on a healthy organ.

On the inner side, the pyloric section is delimited from its body by a narrow transverse groove. The muscle fibers in this area are better developed than in the body, and the thickness of the muscle layer increases as it approaches the duodenum. In addition to smooth circular muscle fibers, it also consists of longitudinal fibers that cover the circular layer on top.

The mucous membrane is covered with folds on the inside. Particularly large longitudinal folds form the so-called food track, located parallel to the axis of the greater curvature of the stomach and facilitating the movement of the digested food mass to the pylorus - the sphincter, which ends the pyloric part of the stomach. This is a ring-shaped muscle, the width of which also depends on the general condition of the organ. On average it is 1–2 centimeters, in some cases decreasing to several millimeters. A tortuous venous network provides blood supply to the sphincter and the entire section.

The folds of the mucous membrane, which form a kind of valve, and the pyloric sphincter play an important role in the process of transporting food from the stomach to the intestines. They separate the dense fractions of its contents from the liquid ones and do not allow food masses to spontaneously flow into the duodenum.

In the pyloric and prepyloric sections of the stomach there are pyloric glands that produce not only digestive enzymes, but also hormones: serotonin, endorphins, somatostatin, and the specific hormone gastrin that stimulates the formation of hydrochloric acid. The pyloric glands of the stomach are responsible for the endocrine function of the organ, influencing metabolic processes throughout the body. Therefore, diseases that affect this area often affect not only the gastrointestinal tract, but also the general condition of the person.

Unlike the secretion of the cardiac and fundic glands, the secretion of the pyloric glands has an alkaline reaction. Therefore, the mucous membrane of the pyloric region is often damaged by increased acidity of the stomach, which leads to various kinds of diseases, ranging from inflammation to malignant tumors.

Stomach cancer stage 3

In every fourth patient, the disease is detected at the third stage, when not in all cases surgery is possible at the first stage, because the tumor is large and there may be more than 16 lymph nodes affected by metastases.

The third stage is characterized by ranking according to three options:

• a process growing outward through the serous membrane of an organ, but without involving neighboring organs, with single or multiple lesions of the lymphatic collector - subtype A;
• the tumor spreads to neighboring structures and no more than two affected lymph nodes, or cancer infiltration within the boundaries of the gastric wall and enlarged lymph nodes more than three - subtype B;
• neoplasm extending beyond the gastric wall with metastases to a large number of lymph nodes - subtype C.

The possibility of performing an operation depends on the involvement of neighboring organs and neurovascular bundles in the cancer conglomerate. For most patients, the treatment program extends to chemotherapy, both before and after surgery. If surgery is not possible due to too much spread in the abdominal cavity, radiation therapy is used against the background of chemotherapy cycles.

Features of regulation of stomach functions

The normal functioning of the stomach and the entire gastrointestinal tract is achieved through both nervous and humoral regulation. Nervous regulation is carried out through the sympathetic and parasympathetic parts of the autonomic nervous system, as well as through the so-called enteric nervous system.

In addition to nervous regulation, humoral mechanisms are also involved in ensuring the normal functioning of the digestive system, which are realized due to the influence of hormones:

• Adrenaline, norepinephrine, acetylcholine.
• Bradykinin, histamine, gastrin.
• Motilin, secretin, gastric inhibitory peptide.

At the same time, many other hormones are also capable of influencing digestion processes in one way or another. In relation to the stomach, the effect of their influence may be to increase or decrease the intensity of muscle contractions of the wall, stimulate, or vice versa, inhibit the secretion of enzymes and hydrochloric acid.

For more information about the human gall bladder and its structure, see the video:

Stomach cancer stage 4

The fourth always means that there are metastases to other organs or the peritoneum, and the tumor can be of any size and no matter the number of lymph nodes affected by malignant cells.

The more aggressive the process, the higher the likelihood of detecting metastases. The malignancy of poorly differentiated adenocarcinoma is much higher than that of high or moderate differentiation. Therefore, the fourth stage is possible with a tiny gastric neoplasm of low differentiation.

Every year, the metastatic stage is detected in 40% of patients, the disease cannot be cured and all efforts come down to a battle with the imminent arrival of death with the help of chemotherapy.