Acromegaly (from Greek akros “extreme” or “extremities” and megalos “large” – extremities enlargement) is a syndrome that results when the pituitary gland produces excess growth hormone (hGH) after epiphyseal plate closure. A number of disorders may be affecting the pituitary to create this circumstance, although most commonly it involves a GH producing tumor derived from a distinct type of cells (somatotrophs) and called pituitary adenoma.
Acromegaly most commonly affects adults in middle age, and can result in severe disfigurement, serious complicating conditions, and premature death if unchecked. Because of its insidious pathogenesis and slow progression, the disease is hard to diagnose in the early stages and is frequently missed for many years, when changes in external features, especially of the face, become noticeable.
Acromegaly is often also associated with gigantism.
Symptoms of Acromegaly
Features that result from high level of hGH or expanding tumor include:
Soft tissue swelling visibly resulting in enlargement of the hands, feet, nose, lips and ears, and a general thickening of the skin
Soft tissue swelling of internal organs, notably read more [...]
Hypothyroidism is the disease state in humans and animals caused by insufficient production of thyroid hormone by the thyroid gland. Cretinism is a form of hypothyroidism found in infants.Causes of Hypothyroidism
About three percent of the general population is hypothyroid. Factors such as iodine deficiency or exposure to Iodine-131 (I-131) can increase that risk. There are a number of causes for overt hypothyroidism. Historically, and still in many developing countries, iodine deficiency is the most common cause of hypothyroidism worldwide. In iodine-replete individuals, hypothyroidism is mostly caused by Hashimoto’s thyroiditis, or by a lack of the thyroid gland or a deficiency of hormones from either the hypothalamus or the pituitary.Hypothyroidism can result from postpartum thyroiditis, a condition that affects about 5% of all women within a year after giving birth. The first phase is typically hyperthyroidism. Then, the thyroid either returns to normal or a woman develops hypothyroidism. Of those women who experience hypothyroidism associated with postpartum thyroiditis, one in five will develop permanent hypothyroidism requiring life-long treatment.Hypothyroidism can read more [...]
Graves’ disease is a thyroid disorder characterized by goitre, exophthalmos, and hyperthyroidism. It is caused by an antibody-mediated auto-immune reaction as to form anti-TSH-Receptor antibody. However, the trigger for this reaction is still unknown. It is the most common cause of hyperthyroidism in the world, and the most common cause of general thyroid enlargement in developed countries.
In some parts of Europe the term Basedow’s disease or Graves-Basedow disease is preferred to Graves’ disease. It was also historically referred to as exophthalmic goiter.
Graves’ disease owes its name to the Irish doctor Mathew Graves , who described a case of goiter with exophthalmos in 1835. However, the German Karl Adolph von Basedow independently reported the same constellation of symptoms in 1840. As a result, on the European Continent the term Basedow’s disease is more common than Graves’ disease.
Several earlier reports exist but were not widely circulated. For example, cases of goiter with exophthalmos were published by the Italians Giuseppe Flajina and Antonio Giuseppe Testicle, in 1802 and 1810 respectively. Prior to these, Caleb Hillier Parry, a read more [...]
A goitre (BrE), or goiter (AmE) (Latin struma), also called a bronchocele, is a swelling in the neck (just below the Adam’s apple or larynx) due to an enlarged thyroid gland.
Classification of Goitre
They are classified in different ways:
A “diffuse goiter” is a goiter that has spread through all of the thyroid (and can be a “simple goitre”, or a “multinodular goitre”).
“Toxic goitre” refers to goitre with hyperthyroidism. These most commonly due to Graves’ disease, but can be caused by inflammation or a multinodular goitre.
“Nontoxic goitre” (associated with normal or low thyroid levels) refers to all other types (such as that caused by lithium or certain other autoimmune diseases).
Other type of classification:
I – palpation struma – in normal posture of head it cannot be seen. Only found when palpating.
II – struma is palpative and can be easily seen.
III – struma is very big and is retrosternal. Pressure and compression marks.
Causes of Goitre
Other causes are:
Hashimoto’s thyroiditis (E06.3)
Graves-Basedow disease (E05.0)
Inborn errors of thyroid hormone synthesis, causing congenital hypothyroidism read more [...]
Diabetes insipidus (DI) is a condition characterized by excretion of large amounts of severely diluted urine, which cannot be reduced when fluid intake is reduced. It denotes inability of the kidney to concentrate urine. DI is caused by a deficiency of antidiuretic hormone (ADH), also known as vasopressin, due to the destruction of the back or “posterior” part of the pituitary gland where vasopressin is normally released from, or by an insensitivity of the kidneys to that hormone. It can also be induced iatrogenically by various drugs.
Signs and symptoms of Diabetes insipidus
Excessive urination and extreme thirst (especially for cold water and sometimes ice or ice water) are typical for DI. Symptoms of diabetes insipidus are quite similar to those of untreated diabetes mellitus, with the distinction that the urine is not sweet as it does not contain glucose and there is no hyperglycemia (elevated blood glucose). Blurred vision is a rarity. Signs of dehydration may also appear in some individuals since the body cannot conserve much (if any) of the water it takes in.
The extreme urination continues throughout the day and the night. In children, DI can interfere with appetite, read more [...]
A bile duct is any of a number of long tube-like structures that carry bile.
Bile, required for the digestion of food, is excreted by the liver into passages that carry bile toward the hepatic duct, which joins with the cystic duct (carrying bile to and from the gallbladder) to form the common bile duct, which opens into the intestine.
The biliary tree (see below) is the whole network of various sized ducts branching through the liver.
The path is as follows: Bile canaliculi → Canals of Hering → interlobular bile ducts → intrahepatic bile ducts → left and right hepatic ducts merge to form → common hepatic duct exits liver and joins → cystic duct (from gall bladder) forming → common bile duct → joins with pancreatic duct → forming ampulla of Vater → enters duodenum
Common bile duct
The top half of the common bile duct is associated with the liver, while the bottom half of the common bile duct is associated with the pancreas, through which it passes on its way to the intestine. It opens in the part of the intestine called the duodenum into a structure called the ampulla of Vater.
Blockage of the bile duct by a cancer, gallstones, or scarring read more [...]
Belching, also known as burping, ructus, or eructation, involves the release of gas from the digestive tract (mainly esophagus and stomach) through the mouth. It is usually accompanied with a typical sound and, at times, an odor.
Belching is typically caused by swallowing air (aerophagia) when eating or drinking and subsequently expelling it, so in this case the expelled gas is mainly a mixture of nitrogen and oxygen. Burps can also be caused by drinking carbonated drinks such as beer, soft drinks, or champagne, in which case the expelled gas is carbon dioxide from the drink itself. Common diabetes drugs metformin  and Byetta  can cause belching, especially at higher doses. This often resolves in a few weeks. Belching combined with other symptoms such as dyspepsia, nausea and heartburn may be a sign of an ulcer or hiatal hernia, and should be reviewed by a physician. 
The sound of burping is caused by the vibration of the upper esophageal sphincter as the gas passes through it. The current Guinness world record for the loudest burp is 118.1 dB, set by Paul Hunn from London, England in 2000. (This would be noticeably louder than a chainsaw at a distance of read more [...]
Appendicitis (or epityphlitis) is a condition characterized by inflammation of the appendix. All cases require removal of the inflamed appendix, either by laparotomy or laparoscopy. Untreated, mortality is high, mainly because of peritonitis and shock. Reginald Fitz first described acute appendicitis in 1886, and it has been recognized as one of the most common causes of severe acute abdominal pain worldwide.
Causes of Appendicitis
Location of the appendix in the digestive system
On the basis of experimental evidence, acute appendicitis seems to be the end result of a primary obstruction of the appendix lumen. Once this obstruction occurs the appendix subsequently becomes filled with mucus and swells, increasing pressures within the lumen and the walls of the appendix, resulting in thrombosis and occlusion of the small vessels, and stasis of lymphatic flow. Rarely, spontaneous recovery can occur at this point. As the former progresses, the appendix becomes ischemic and then necrotic. As bacteria begin to leak out through the dying walls, pus forms within and around the appendix (suppuration). The end result of this cascade is appendiceal rupture read more [...]
Crohn’s disease is a disease of the digestive system which may affect any part of the gastrointestinal tract from mouth to anus. As a result, the symptoms of Crohn’s disease can vary significantly among afflicted individuals. The main gastrointestinal symptoms are abdominal pain, diarrhea (which may be visibly bloody), vomiting, or weight loss. Crohn’s disease can also cause complications outside of the gastrointestinal tract such as skin rashes, arthritis, and inflammation of the eye.
The precise cause of Crohn’s disease is not known. The disease occurs when the immune system attacks the gastrointestinal tract and for this reason, Crohn’s disease is considered an autoimmune disease. This autoimmune activity produces inflammation in the gastrointestinal tract, and therefore Crohn’s disease is classified as an inflammatory bowel disease.
Like many other autoimmune diseases, Crohn’s disease is believed to be genetically linked. The highest risk occurs in individuals with siblings who have the disease. Males and females are equally affected. Smokers are three times more likely to develop Crohn’s disease. Crohn disease affects between 400,000 and 600,000 read more [...]
Cholecystitis is inflammation of the gall bladder.
Causes and pathology of Cholecystitis
Cholecystitis is often caused by cholelithiasis (the presence of choleliths, or gallstones, in the gallbladder), with choleliths most commonly blocking the cystic duct directly. This leads to inspissation of bile, bile stasis, and secondary infection by gut organisms, predominantly E coli and Bacteroides species.
The gallbladder’s wall becomes inflamed. Extreme cases may result in necrosis and rupture. Inflammation often spreads to its outer covering, thus irritating surrounding structures such as the diaphragm and bowel.
Less commonly, in debilitated and trauma patients, the gallbladder may become inflamed and infected in the absence of cholelithiasis, and is known as acute acalculous cholecystitis.
Stones in the gallbladder may not cause obstruction and the accompanying acute attack. The patient might develop a chronic, low-level inflammation which leads to a chronic cholecystitis, where the gallbladder is fibrotic and calcified.
Symptoms of Cholecystitis
Cholecystitis usually presents as a pain in the right upper quadrant. This is usually a constant, severe pain. The pain read more [...]