Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-78c5997874-dh8gc Total loading time: 0 Render date: 2024-11-17T13:12:58.790Z Has data issue: false hasContentIssue false

Chapter 22 - The Gastrointestinal Tract in the Elder

Published online by Cambridge University Press:  11 July 2020

By
Xuchen Zhang  and
Dhanpat Jain
Edited by
Kim A. Collins  and
Roger W. Byard
Kim A. Collins
Affiliation:
LifePoint Inc, South Carolina
Roger W. Byard
Affiliation:
University of Adelaide
Get access

Summary

The gastrointestinal (GI) system comprises a muscular tube starting from the mouth and ending at the anus, with a lining epithelium that ranges from squamous to columnar epithelium, and accessory organs that include the liver, gallbladder, and pancreas. The muscular tube consists of the esophagus, stomach, small and large intestines, and anal canal.

Type
Chapter
Information
Geriatric Forensic Medicine and Pathology , pp. 375 - 404
Publisher: Cambridge University Press
Print publication year: 2020

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Fuentes, E, Fuentes, M, Alarcon, M, Palomo, I. Immune system dysfunction in the elderly. An Acad Bras Cienc. 2017;89(1):285–99.Google Scholar
Nolen, SC, Evans, MA, Fischer, A, et al. Cancer: incidence, prevalence and mortality in the oldest-old. A comprehensive review. Mech Ageing Dev. 2017;164:113–26.CrossRefGoogle ScholarPubMed
Shaker, R, Staff, D.Esophageal disorders in the elderly. Gastroenterol Clin North Am. 2001;30(2):335–61, vii–viii.Google Scholar
Pusztaszeri, MP, Genta, RM, Cryer, BL. Drug-induced injury in the gastrointestinal tract: clinical and pathologic considerations. Nat Clin Pract Gastroenterol Hepatol. 2007;4(8):442–53.Google Scholar
Byard, RW. Esophageal causes of sudden and unexpected death. J Forensic Sci. 2006;51(2):390–5.CrossRefGoogle ScholarPubMed
Kwak, HA, Hart, J. The many faces of medication-related injury in the gastrointestinal tract. Surg Pathol Clin. 2017;10(4):887–908.Google Scholar
Byard, RW. Lethal aorto-oesophageal fistula – characteristic features and aetiology. J Forensic Leg Med. 2013;20(3):164–8.Google Scholar
Purdy, JK, Appelman, HD, McKenna, BJ. Sloughing esophagitis is associated with chronic debilitation and medications that injure the esophageal mucosa. Mod Pathol. 2012;25(5):767–75.Google Scholar
Moawad, FJ, Appleman, HD. Sloughing esophagitis: a spectacular histologic and endoscopic disease without a uniform clinical correlation. Ann N Y Acad Sci. 2016;1380(1):178–82.Google Scholar
Murro, D, Jakate, S. Radiation esophagitis. Arch Pathol Lab Med. 2015;139(6):827–30.CrossRefGoogle ScholarPubMed
Sharara, AI, Rockey, DC. Gastroesophageal variceal hemorrhage. N Engl J Med. 2001;345(9):669–81.CrossRefGoogle ScholarPubMed
Biecker, E. Gastrointestinal bleeding in cirrhotic patients with portal hypertension. ISRN Hepatol. 2013;2013:541836.Google Scholar
Kim, YS, Kim, N, Kim, GH. Sex and gender differences in gastroesophageal reflux disease. J Neurogastroenterol Motil. 2016;22(4):575–88.Google Scholar
Allende, DS, Yerian, LM. Diagnosing gastroesophageal reflux disease: the pathologist’s perspective. Adv Anat Pathol. 2009;16(3):161–5.Google Scholar
Dunbar, KB, Agoston, AT, Odze, RD, et al. Association of acute gastroesophageal reflux disease with esophageal histologic changes. JAMA. 2016;315(19):2104–12.Google Scholar
Shaheen, NJ, Falk, GW, Iyer, PG, Gerson, LB; American College of Gastroenterology. ACG Clinical Guideline: Diagnosis and Management of Barrett’s Esophagus. Am J Gastroenterol. 2016;111(1):30–50;quiz 1.Google Scholar
Abrams, JA, Fields, S, Lightdale, CJ, Neugut, AI. Racial and ethnic disparities in the prevalence of Barrett’s esophagus among patients who undergo upper endoscopy. Clin Gastroenterol Hepatol. 2008;6(1):30–4.Google Scholar
Gopal, DV, Lieberman, DA, Magaret, N, et al. Risk factors for dysplasia in patients with Barrett’s esophagus (BE): results from a multicenter consortium. Dig Dis Sci. 2003;48(8):1537–41.Google Scholar
Byard, RW. Barrett esophagus and unexpected death. Am J Forensic Med Pathol. 2007;28(2):147–9.CrossRefGoogle ScholarPubMed
Thrift, AP. The epidemic of oesophageal carcinoma: Where are we now? Cancer Epidemiol. 2016;41:88–95.CrossRefGoogle ScholarPubMed
Britton, E, McLaughlin, JT. Ageing and the gut. Proc Nutr Soc. 2013;72(1):173–7.CrossRefGoogle ScholarPubMed
Venerito, M, Vasapolli, R, Rokkas, T, Delchier, JC, Malfertheiner, P. Helicobacter pylori, gastric cancer and other gastrointestinal malignancies. Helicobacter. 2017;22 Suppl 1.Google Scholar
Sipponen, P. Update on the pathologic approach to the diagnosis of gastritis, gastric atrophy, and Helicobacter pylori and its sequelae. J Clin Gastroenterol. 2001;32(3):196–202.Google Scholar
Sipponen, P. Helicobacter pylori: a cohort phenomenon. Am J Surg Pathol. 1995;19 Suppl 1:S30–6.Google Scholar
Polydorides, AD. Pathology and differential diagnosis of chronic, noninfectious gastritis. Semin Diagn Pathol. 2014;31(2):114–23.Google ScholarPubMed
Cockburn, AN, Morgan, CJ, Genta, RM. Neuroendocrine proliferations of the stomach: a pragmatic approach for the perplexed pathologist. Adv Anat Pathol. 2013;20(3):148–57.CrossRefGoogle ScholarPubMed
Pounder, R. Silent peptic ulceration: deadly silence or golden silence? Gastroenterology. 1989;96(2 Pt 2 Suppl): 626–31.CrossRefGoogle ScholarPubMed
Schmocker, RK, Lidor, AO. Management of non-neoplastic gastric lesions. Surg Clin North Am. 2017;97(2):387–403.Google Scholar
Kennedy, JS, Hanly, E, Marohn, MR, Arciero, C, Mittendorf, EA. Management of giant gastric ulcers: case report and review of the literature. Curr Surg. 2004;61(2):220–3.Google Scholar
Linton, A, Garber, M, Fagan, NK, Peterson, MR. Examination of multiple medication use among TRICARE beneficiaries aged 65 years and older. J Manag Care Pharm. 2007;13(2):155–62.Google Scholar
De Petris, G, Caldero, SG, Chen, LW, et al. Histopathological changes in the gastrointestinal tract due to medications: an update for the surgical pathologist (Part II of II). Int J Surg Pathol. 2014;22(3):202–11.Google ScholarPubMed
Mukaisho, K, Hagiwara, T, Nakayama, T, Hattori, T, Sugihara, H. Potential mechanism of corpus-predominant gastritis after PPI therapy in Helicobacter pylori-positive patients with GERD. World J Gastroenterol. 2014;20(34):11962–5.Google Scholar
Marginean, EC, Bennick, M, Cyczk, J, Robert, ME, Jain, D. Gastric siderosis: patterns and significance. Am J Surg Pathol. 2006;30(4):514–20.Google Scholar
Villadolid, J, Amin, A. Immune checkpoint inhibitors in clinical practice: update on management of immune-related toxicities. Transl Lung Cancer Res. 2015;4(5):560–75.Google Scholar
Boike, J, Dejulio, T. Severe esophagitis and gastritis from nivolumab therapy. ACG Case Rep J. 2017;4:e57.CrossRefGoogle ScholarPubMed
Pucci, P, Rescigno, P, Sumanasuriya, S, de Bono, J, Crea, F. Hypoxia and noncoding RNAs in taxane resistance. Trends Pharmacol Sci. 2018;39(8):695–709.Google Scholar
Daniels, JA, Gibson, MK, Xu, L, et al. Gastrointestinal tract epithelial changes associated with taxanes: marker of drug toxicity versus effect. Am J Surg Pathol. 2008;32(3):473–7.Google Scholar
Thuluvath, PJ, Yoo, HY. Portal hypertensive gastropathy. Am J Gastroenterol. 2002;97(12):2973–8.Google Scholar
Fuccio, L, Mussetto, A, Laterza, L, Eusebi, LH, Bazzoli, F. Diagnosis and management of gastric antral vascular ectasia. World J Gastrointest Endosc. 2013;5(1):6–13.CrossRefGoogle ScholarPubMed
Lemmers, A, Evrard, S, Demetter, P, et al. Gastrointestinal polypoid lesions: a poorly known endoscopic feature of portal hypertension. United Euro Gastroenterol J. 2014;2(3):189–96.CrossRefGoogle ScholarPubMed
Gretz, JE, Achem, SR. The watermelon stomach: clinical presentation, diagnosis, and treatment. Am J Gastroenterol. 1998;93(6):890–5.CrossRefGoogle ScholarPubMed
Payen, JL, Cales, P, Voigt, JJ, et al. Severe portal hypertensive gastropathy and antral vascular ectasia are distinct entities in patients with cirrhosis. Gastroenterology. 1995;108(1):138–44.CrossRefGoogle ScholarPubMed
Dulai, GS, Jensen, DM. Treatment of watermelon stomach. Curr Treat Options Gastroenterol. 2006;9(2):175–80.Google Scholar
Vyas, M, Yang, X, Zhang, X. Gastric hamartomatous polyps: review and update. Clin Med Insights Gastroenterol. 2016;9:3–10.Google Scholar
Carmack, SW, Genta, RM, Schuler, CM, Saboorian, MH. The current spectrum of gastric polyps: a 1-year national study of over 120,000 patients. Am J Gastroenterol. 2009;104(6):1524–32.CrossRefGoogle ScholarPubMed
Castro, R, Pimentel-Nunes, P, Dinis-Ribeiro, M. Evaluation and management of gastric epithelial polyps. Best Pract Res Clin Gastroenterol. 2017;31(4):381–7.Google Scholar
Stolte, M, Vieth, M, Ebert, MP. High-grade dysplasia in sporadic fundic gland polyps: clinically relevant or not? Eur J Gastroenterol Hepatol. 2003;15(11):1153–6.CrossRefGoogle ScholarPubMed
Arnason, T, Liang, WY, Alfaro, E, et al. Morphology and natural history of familial adenomatous polyposis-associated dysplastic fundic gland polyps. Histopathology. 2014;65(3):353–62.Google Scholar
Shaib, YH, Rugge, M, Graham, DY, Genta, RM. Management of gastric polyps: an endoscopy-based approach. Clin Gastroenterol Hepatol. 2013;11(11):1374–84.Google Scholar
Brenner, H, Rothenbacher, D, Arndt, V. Epidemiology of stomach cancer. Methods Mol Biol. 2009;472:467–77.Google Scholar
Yakirevich, E, Resnick, MB. Pathology of gastric cancer and its precursor lesions. Gastroenterol Clin North Am. 2013;42(2):261–84.Google Scholar
Bosman, FT, Carneiro, F, Hruban, RH, Theise, HD. WHO Classification of Tumours of the Digestive System. 4th edn. Lyon: IARC; 2010, pp. 48–58.Google Scholar
Baker, NR, Blakely, KK. Gastrointestinal disturbances in the elderly. Nurs Clin North Am. 2017;52(3):419–31.Google Scholar
Ghoshal, UC, Ghoshal, U. Small intestinal bacterial overgrowth and other intestinal disorders. Gastroenterol Clin North Am. 2017;46(1):103–20.Google Scholar
Holmes, GKT, Muirhead, A. Epidemiology of coeliac disease in a single centre in Southern Derbyshire 1958–2014. BMJ Open Gastroenterol. 2017;4(1):e000137.Google Scholar
West, J, Logan, RF, Hill, PG, et al. Seroprevalence, correlates, and characteristics of undetected coeliac disease in England. Gut. 2003;52(7):960–5.Google Scholar
Robert, ME, Crowe, SE, Burgart, L, et al. Statement on Best Practices in the Use of Pathology as a Diagnostic Tool for Celiac Disease: a guide for clinicians and pathologists. Am J Surg Pathol. 2018;42(9):e44–e58.Google Scholar
Sergi, C, Shen, F, Bouma, G. Intraepithelial lymphocytes, scores, mimickers and challenges in diagnosing gluten-sensitive enteropathy (celiac disease). World J Gastroenterol. 2017;23(4):573–89.Google Scholar
Rishi, AR, Rubio-Tapia, A, Murray, JA. Refractory celiac disease. Expert Rev Gastroenterol Hepatol. 2016;10(4):537–46.Google Scholar
Rubio-Tapia, A, Kelly, DG, Lahr, BD, et al. Clinical staging and survival in refractory celiac disease: a single center experience. Gastroenterology. 2009;136(1):99–107; quiz 352–3.Google Scholar
Akram, S, Murray, JA, Pardi, DS, et al. Adult autoimmune enteropathy: Mayo Clinic Rochester experience. Clin Gastroenterol Hepatol. 2007;5(11):1282–90; quiz 45.Google Scholar
Masia, R, Peyton, S, Lauwers, GY, Brown, I. Gastrointestinal biopsy findings of autoimmune enteropathy: a review of 25 cases. Am J Surg Pathol. 2014;38(10):1319–29.Google Scholar
Bonilla, FA, Barlan, I, Chapel, H, et al. International Consensus Document (ICON): Common Variable Immunodeficiency Disorders. J Allergy Clin Immunol Pract. 2016;4(1):38–59.Google Scholar
Goldstein, JL, Eisen, GM, Lewis, B, et al. Video capsule endoscopy to prospectively assess small bowel injury with celecoxib, naproxen plus omeprazole, and placebo. Clin Gastroenterol Hepatol. 2005;3(2):133–41.CrossRefGoogle ScholarPubMed
Drini, M. Peptic ulcer disease and non-steroidal anti-inflammatory drugs. Aust Prescr. 2017;40(3):91–3.Google Scholar
Rubio-Tapia, A, Herman, ML, Ludvigsson, JF, et al. Severe spruelike enteropathy associated with olmesartan. Mayo Clin Proc. 2012;87(8):732–8.CrossRefGoogle ScholarPubMed
Ianiro, G, Bibbo, S, Montalto, M, et al. Systematic review: Sprue-like enteropathy associated with olmesartan. Aliment Pharmacol Ther. 2014;40(1):16–23.Google Scholar
Rashid, A, Hamilton, SR. Necrosis of the gastrointestinal tract in uremic patients as a result of sodium polystyrene sulfonate (Kayexalate) in sorbitol: an underrecognized condition. Am J Surg Pathol. 1997;21(1):60–9.Google Scholar
Swanson, BJ, Limketkai, BN, Liu, TC, et al. Sevelamer crystals in the gastrointestinal tract (GIT): a new entity associated with mucosal injury. Am J Surg Pathol. 2013;37(11):1686–93.CrossRefGoogle Scholar
Barakat, M, Mostafa, M, Mahran, Z, Soliman, AG. Portal hypertensive duodenopathy: clinical, endoscopic, and histopathologic profiles. Am J Gastroenterol. 2007;102(12):2793–802.Google Scholar
Zeitoun, JD, Chryssostalis, A, Terris, B, et al. Portal hypertensive duodenal polyp: a case report. World J Gastroenterol. 2007;13(9):1451–2.Google Scholar
Gurung, A, Jaffe, PE, Zhang, X. Duodenal polyposis secondary to portal hypertensive duodenopathy. World J Gastrointest Endosc. 2015;7(17):1257–61.CrossRefGoogle ScholarPubMed
Carver, TW, Vora, RS, Taneja, A. Mesenteric ischemia. Crit Care Clin. 2016;32(2):155–71.Google Scholar
Byard, RW. Acute mesenteric ischaemia and unexpected death. J Forensic Leg Med. 2012;19(4):185–90.Google Scholar
Byard, RW. Mesenteric venous thrombosis. Forensic Sci Med Pathol. 2012;8(4):475–6.CrossRefGoogle ScholarPubMed
Karkkainen, JM, Acosta, S. Acute mesenteric ischemia (part I) – incidence, etiologies, and how to improve early diagnosis. Best Pract Res Clin Gastroenterol. 2017;31(1):15–25.Google Scholar
Clair, DG, Beach, JM. Mesenteric ischemia. N Engl J Med. 2016;374(10):959–68.Google Scholar
Lawson, RM. Mesenteric ischemia. Crit Care Nurs Clin North Am. 2018;30(1):29–39.Google Scholar
Cerilli, LA, Greenson, JK. The differential diagnosis of colitis in endoscopic biopsy specimens: a review article. Arch Pathol Lab Med. 2012;136(8):854–64.Google Scholar
De Petris, G, Gatius Caldero, S, Chen, LW, et al. Histopathological Changes in the Gastrointestinal Tract Due to Drugs: An Update for the Surgical Pathologist (Part I of II). International Journal of Surgical Pathology. 2014;22(2):120–8.Google Scholar
Kurnatowska, I, Banasiak, M, Daniel, P, Wagrowska-Danilewicz, M, Nowicki, M. Two cases of severe de novo colitis in kidney transplant recipients after conversion to prolonged-release tacrolimus. Transpl Int. 2010;23(5):553–8.Google Scholar
Star, KV, Ho, VT, Wang, HH, Odze, RD. Histologic features in colon biopsies can discriminate mycophenolate from GVHD-induced colitis. Am J Surg Pathol. 2013;37(9):1319–28.Google Scholar
Assarzadegan, N, Montgomery, E, Anders, RA. Immune checkpoint inhibitor colitis: the flip side of the wonder drugs. Virchows Arch. 2018;472(1):125–33.Google Scholar
Celli, R, Kluger, HM, Zhang, X. Anti-PD-1 Therapy-associated perforating colitis. Case Rep Gastrointest Med. 2018;2018:3406437.Google Scholar
Travis, S. Is IBD different in the elderly? Inflammatory Bowel Diseases. 2008;14:S12–S3.Google Scholar
Everhov, AH, Halfvarson, J, Myrelid, P, et al. Incidence and treatment of patients diagnosed with inflammatory bowel diseases at 60 years or older in Sweden. Gastroenterology. 2018;154(3):518–+.Google Scholar
Yantiss, RK, Sapp, HL, Farraye, FA, et al. Histologic predictors of pouchitis in patients with chronic ulcerative colitis. Am J Surg Pathol. 2004;28(8):999–1006.Google Scholar
Haskell, H, Andrews, CW, Jr., Reddy, SI, et al. Pathologic features and clinical significance of “backwash” ileitis in ulcerative colitis. Am J Surg Pathol. 2005;29(11):1472–81.Google Scholar
Feakins, RM. Ulcerative colitis or Crohn’s disease? Pitfalls and problems. Histopathology. 2014;64(3):317–35.Google Scholar
Loughrey, MB, Shepherd, NA. Diagnostic dilemmas in chronic inflammatory bowel disease. Virchows Archiv. 2018;472(1):81–97.Google Scholar
Tong, JL, Zheng, Q, Zhang, CP, Lo, RY, Shen, J, Ran, ZH. Incidence, prevalence, and temporal trends of microscopic colitis: a systematic review and meta-analysis. Am Gastroenterol. 2015;110(2):265–76.Google Scholar
Humphrey, PA, Dehner, LP, Pfeifer, JD. The Washington Manual of Surgical Pathology: Wolters Kluwer; 2008. 195 p.Google Scholar
Farrell, RJ, Farrell, JJ, Morrin, MM. Diverticular disease in the elderly. Gastroenterol Clin North Am. 2001;30(2):475–96.Google Scholar
Mulhall, AM, Mahid, SS, Petras, RE, Galandiuk, S. Diverticular disease associated with inflammatory bowel disease-like colitis: a systematic review. Dis Colon Rectum. 2009;52(6):1072–9.Google Scholar
Ezer, A, Parlakgumus, A. Solitary cecal diverticulitis mimicking cecal carcinoma. J Coll Physicians Surg Pak. 2018;28(6):S75–S7.Google Scholar
Urrunaga, NH, Rockey, DC. Portal hypertensive gastropathy and colopathy. Clin Liver Dis. 2014;18(2):389–406.Google Scholar
Al-Busafi, SA, McNabb-Baltar, J, Farag, A, Hilzenrat, N. Clinical manifestations of portal hypertension. Int J Hepatol. 2012;2012:203794.Google Scholar
Thelmo, WL, Vetrano, JA, Wibowo, A, Dimaio, TM, Cruzvetrano, WP, Kim, DS. Angiodysplasia of colon revisited – pathological demonstration without the use of intravascular injection technique. Hum Pathol. 1992;23(1):37–40.Google Scholar
Guttenplan, M. The evaluation and office management of hemorrhoids for the gastroenterologist. Curr Gastroenterol Rep. 2017;19(7):30.CrossRefGoogle ScholarPubMed
Kanchan, T, Menezes, RG, Manipady, S. Haemorrhoids leading to post-mortem bleeding artefact. J Clin Forensic Med. 2006;13(5):277–9.Google Scholar
Ma, X, Ma, H, Zhu, J, Liu, J. Clinical Characteristics of ischemic colitis in elderly patients. Hepatogastroenterology. 2015;62(139):620–3.Google Scholar
Fenster, M, Feuerstadt, P, Brandt, LJ, Mansoor, MS, Huisman, T, Aroniadis, OC. Real-world multicentre experience of the pathological features of colonic ischaemia and their relationship to symptom duration, disease distribution and clinical outcome. Colorectal Dis. 2018:Jul 3. doi: 10.1111/codi.14323. [Epub ahead of print].Google Scholar
Theodoropoulou, A, Koutroubakis, IE. Ischemic colitis: Clinical practice in diagnosis and treatment. World J Gastroentero. 2008;14(48):7302–8.Google Scholar
Strum, WB. Colorectal adenomas. N Engl J Med. 2016;374(11):1065–75.Google Scholar
Rex, DK, Ahnen, DJ, Baron, JA, et al. Serrated lesions of the colorectum: review and recommendations from an expert panel. Am J Gastroenterol. 2012;107(9):1315–29;quiz 4, 30.Google Scholar
Schmucker, DL. Age-related changes in liver structure and function: Implications for disease? Exp Gerontol. 2005;40(8–9):650–9.Google Scholar
Klotz, U. Pharmacokinetics and drug metabolism in the elderly. Drug Metab Rev. 2009;41(2):67–76.Google Scholar
Kim, IH, Kisseleva, T, Brenner, DA. Aging and liver disease. Curr Opin Gastroenterol. 2015;31(3):184–91.Google Scholar
Landry, ML KS, Jain, D. Subacute liver failure due to autochthonous hepatitis E virus infection in an elderly man in the United States. Hum Pathol Case Reports. 2018;12:68–70.Google Scholar
Deutsch, M, Emmanuel, T, Koskinas, J. Autoimmune hepatitis or Wilson’s disease, a clinical dilemma. Hepat Mon. 2013;13(5):e7872.Google Scholar
Gupta, E, Ballani, N, Kumar, M, Sarin, SK. Role of non-hepatotropic viruses in acute sporadic viral hepatitis and acute-on-chronic liver failure in adults. Indian J Gastroenterol. 2015;34(6):448–52.Google Scholar
Tsochatzis, EA, Bosch, J, Burroughs, AK. Liver cirrhosis. Lancet. 2014;383(9930):1749–61.Google Scholar
Younossi, ZM, Koenig, AB, Abdelatif, D, Fazel, Y, Henry, L, Wymer, M. Global epidemiology of nonalcoholic fatty liver disease-Meta-analytic assessment of prevalence, incidence, and outcomes. Hepatology. 2016;64(1):73–84.Google Scholar
Mahiuddin Ahammed, SK, Chowdhury, A. Cryptogenic cirrhosis and NASH: entities in evolution and involution. Trop Gastroenterol. 2014;35(2):65–70.Google Scholar
Chen, J, Eslick, GD, Weltman, M. Systematic review with meta-analysis: clinical manifestations and management of autoimmune hepatitis in the elderly. Aliment Pharmacol Ther. 2014;39(2):117–24.Google Scholar
Al-Chalabi, T, Boccato, S, Portmann, BC, McFarlane, IG, Heneghan, MA. Autoimmune hepatitis (AIH) in the elderly: A systematic retrospective analysis of a large group of consecutive patients with definite AM followed at a tertiary referral centre. Journal of Hepatology. 2006;45(4):575–83.Google Scholar
Rizvi, S, Gawrieh, S. Autoimmune hepatitis in the elderly: diagnosis and pharmacologic management. Drugs Aging. 2018;35(7):589–602.Google Scholar
Griffiths, L, Dyson, JK, Jones, DE. The new epidemiology of primary biliary cirrhosis. Semin Liver Dis. 2014;34(3):318–28.CrossRefGoogle ScholarPubMed
Colina, F, Pinedo, F, Solis, JA, Moreno, D, Nevado, M. Nodular regenerative hyperplasia of the liver in early histological stages of primary biliary cirrhosis. Gastroenterology. 1992; 102 (4 Pt 1): 1319–24.Google Scholar
Riviere, E, Vergniol, J, Reffet, A, Lippa, N, Le Bail, B, de Ledinghen, V. Gastric variceal bleeding uncovering a rare association of CREST syndrome, primary biliary cirrhosis, nodular regenerative hyperplasia and pulmonary hypertension. Eur J Gastroenterol Hepatol. 2010;22(9):1145–8.CrossRefGoogle ScholarPubMed
Lazaridis, KN, LaRusso, NF. Primary sclerosing cholangitis. N Engl J Med. 2016;375(12):1161–70.Google Scholar
Molodecky, NA, Kareemi, H, Parab, R, et al. Incidence of primary sclerosing cholangitis: a systematic review and meta-analysis. Hepatology. 2011;53(5):1590–9.Google Scholar
Dyson, JK, Beuers, U, Jones, DEJ, Lohse, AW, Hudson, M. Primary sclerosing cholangitis. Lancet. 2018;391(10139):2547–59.Google Scholar
Gossard, AA, Angulo, P, Lindor, KD. Secondary sclerosing cholangitis: a comparison to primary sclerosing cholangitis. Am J Gastroenterol. 2005;100(6):1330–3.Google Scholar
Siegel, RL, Miller, KD, Jemal, A. Cancer statistics, 2018. CA Cancer J Clin. 2018;68(1):7–30.Google Scholar
El-Serag, HB. Hepatocellular carcinoma. N Engl J Med. 2011;365(12):1118–27.Google Scholar
Torbenson, MS. Morphologic subtypes of hepatocellular carcinoma. Gastroenterol Clin North Am. 2017;46(2):365–91.CrossRefGoogle ScholarPubMed
Banales, JM, Cardinale, V, Carpino, G, et al. Expert consensus document: Cholangiocarcinoma: current knowledge and future perspectives consensus statement from the European Network for the Study of Cholangiocarcinoma (ENS-CCA). Nat Rev Gastroenterol Hepatol. 2016;13(5):261–80.Google Scholar
Krasinskas, AM. Cholangiocarcinoma. Surg Pathol Clin. 2018;11(2):403–29.CrossRefGoogle ScholarPubMed
Kim, IS, Myung, SJ, Lee, SS, Lee, SK, Kim, MH. Classification and nomenclature of gallstones revisited. Yonsei Med J. 2003;44(4):561–70.Google Scholar
Patel, S, Roa, JC, Tapia, O, et al. Hyalinizing cholecystitis and associated carcinomas: clinicopathologic analysis of a distinctive variant of cholecystitis with porcelain-like features and accompanying diagnostically challenging carcinomas. Am J Surg Pathol. 2011;35(8):1104–13.Google Scholar
Shaffer, EA. Gallbladder cancer: the basics. Gastroenterol Hepatol (N Y). 2008;4(10):737–41.Google Scholar
Aloia, TA, Jarufe, N, Javle, M, et al. Gallbladder cancer: expert consensus statement. HPB (Oxford). 2015;17(8):681–90.CrossRefGoogle ScholarPubMed
Matsuda, Y. Age-related pathological changes in the pancreas. Front Biosci (Elite Ed). 2018;10:137–42.Google Scholar
Forsmark, CE, Vege, SS, Wilcox, CM. Acute pancreatitis. N Engl J Med. 2016;375(20):1972–81.Google Scholar
Kloppel, G. Acute pancreatitis. Semin Diagn Pathol. 2004;21(4):221–6.Google Scholar
Kleeff, J, Whitcomb, DC, Shimosegawa, T, et al. Chronic pancreatitis. Nature Rev Dis Primers. 2017;3.Google Scholar
Lowenfels, AB, Maisonneuve, P, Cavallini, G, et al. Pancreatitis and the risk of pancreatic cancer. International Pancreatitis Study Group. N Engl J Med. 1993;328(20):1433–7.Google Scholar
Tong, GX, Geng, QQ, Chai, J, et al. Association between pancreatitis and subsequent risk of pancreatic cancer: a systematic review of epidemiological studies. Asian Pac J Cancer Prev. 2014;15(12):5029–34.Google Scholar
Hart, PA, Zen, Y, Chari, ST. Recent advances in autoimmune pancreatitis. Gastroenterology. 2015;149(1):39–51.Google Scholar
Sah, RP, Chari, ST, Pannala, R, et al. Differences in clinical profile and relapse rate of type 1 versus type 2 autoimmune pancreatitis. Gastroenterology. 2010;139(1):140–8;quiz e12–3.Google Scholar
Ryan, DP, Hong, TS, Bardeesy, N. Pancreatic adenocarcinoma. N Engl J Med. 2014;371(11):1039–49.CrossRefGoogle ScholarPubMed
Hruban, RH, Klimstra, DS. Adenocarcinoma of the pancreas. Seminars in Diagnostic Pathology. 2014;31(6):443–51.Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×