Web Users Please Note:

New Version! Now contains Radiology Studies! (Look for this symbol if it has a blue border, you can click on the skull symbol and see the radiology study)

This is a textbook on gastroenterology. It is copyrighted material and is on the web only as a temporary evaluation, to see if this is a medium which works for teaching clinical medicine, with this type of text. Feel free to read this material, but we trust your integrity to not copy it.

The material has been modified from the original by putting it into html format for the web, and by adding some updated text material and a fair number of new radiology studies. Modifications by Wesley Snyder, Ph.D., who accepts all blame for any innaccuracies in this DRAFT version.

In order to be efficient with net usage, the images are all tiny, "postage stamp" size. However, these images are "hot", that is, if you will click on the image, you will get a full size copy on your screen to peruse at your leisure.


This series is the collaborative work of a decade of Bowman Gray School of Medicine/Wake Forest University faculty. The original edition of this work was designed as a synopsis of medical sciences and intended as a complete first year curriculum for the training of Physician Assistants. It was appropriately entitled "Medical Sciences for Clinical Practice - A Self-Instructional Tutorial Curriculum." This text series has been exceptionally successful in the development of excellence in the education of Physician Assistants at this institution. With the explosion of medical science information, numerous revisions have been made to the original series by countless members of the faculty of the Bowman Gray School of Medicine.

It has been the decision of the current revising team for this text to make a significant change in the orientation of this series. Not only does the series have a new name "The Self Instructional Medical Series," but each text addresses in greater depth both the medical and clinical sciences of each body system. The changes in this series should accommodate many health professionals inclusively both nursing students and medical students. We are grateful to the many individuals who participated in the development and revision of the original text which served as the model for the new "Self Instructional Medical Series."

Editor's Note to Our Students

The Self-Instructional Medical Series has been developed to meet the educational needs of Physician Assistant students. This is not to imply that the series will meet all of the educational needs of the student, for that could never be possible in one series or course.

Education is a lifelong process, and this can never be truer than in the medical field, which is continually evolving and expanding. This series is a starting point of material for the student to master. Basic anatomy and physiology for each system is presented, followed by abnormal presentations and disease processes. The information from these texts, used in conjunction with the required curriculum and faculty support, will enable the student to emerge with a broad base from which to build. The student will develop patterns of independent learning and skills of analytical thinking which will be the foundation for further learning.

The use of the Self-Instructional Medical Series at Bowman Gray School of Medicine Physician Assistant Program is one of an integrated approach. Each unit material is correlated with other course work. For example, the Respiratory Unit, which spans three weeks of study, is scheduled in conjunction with the physical exam technique of the thorax, learning normal and abnormal findings, the clinical pathology of respiratory diseases, the pharmacology of respiratory diseases, study of the thorax in the anatomy lab, clinical case studies with problems focusing on respiratory diseases, and emergency medicine focusing on acute presentations of the chest.

The Self-Instructional Medical Series is shown to be complemented by the balance of the curriculum in such a manner that the student is very focused. This enables the student to explore one system at a time including all aspects of the system. This has proved to be very successful for the building of medical knowledge.

Introduction to Clinical Medicine



Module 1: Basic Structure and Function

minicourse 1: The Upper G.I. Tract

Section 1: Abdominal Wall Landmarks

Section 2: Quadrants of the Abdominal Wall

Section 3: Major Abdominal Wall Muscles

Section 4: Abdominal organs

Section 5: Palpation of Abdominal Organs

Section 6: Hernias

Section 7: Esophagus

Section 8: Stomach

Section 9: Pathophysiology of the Stomach

Section 10: Diaphragmatic Hernias

Section 11: Peptic Ulcers

Minicourse 2: The Lower G.I. Tract
Section 1: The Small Intestine

Section 2: The Large Intestine

Section 3: Abdominal Circulation

Section 4: Peristalsis and Innervation

Section 5: Intestinal Obstruction

Section 6: The Appendix

Section 7: Motility of the Alimentary Canal

Minicourse 3: Liver, Gallbladder, Pancreas and Related Organs

Section 1: Location of the Liver

Section 2: Location, Structure and Function

Section 3: Functions of the Liver

Section 4: Cirrhosis of the Liver

Section 5: The Gallbladder

Section 6: Gallstones

Section 7: The Pancreas

Module 2: Diseases and Malfunctions

Minicourse 1: Overactivity of the Intestinal Tract
Section 1: Types and Causes of G.I. Tract Obstruction
Section 2: Laboratory Approaches to G.I. Overactivity
Section 3: The Pharmacology of G.I. Hypermotility
Section 4: Treatment Plans for Hypermotility
Section 5: Case Studies

Minicourse 2: Ulcer Diseases
Section 1: Signs, Symptoms, Causes and Natural History
Section 2: Ulcer Disease - Pathophysiology
Section 3: Laboratory and X-ray Findings in Peptic Ulcer
Section 4: Treatment of Peptic Ulcers
Section 5: Differential Diagnosis

Minicourse 3: Diseases of the Liver

Section 1: Pasic Pathophysiology of Liver Disease
Section 2: Liver Disease - Prime Clinical Features
Section 3: Laboratory Evaluation of Liver Disease
Section 4: Treatment of Hepatitis and Cirrhosis
Section 5: Problem Cases

Minicourse 4: The Acute Abdomen

Section 1: Definition of the Acute Abdomen
Section 2: Cause and Pathophysiology of Acute Abdomen
Section 3: Clinical Characteristics of the Acute Abdomen
Section 4: Surgical vs. Non-Surgical Acute Abdomen
Section 5: Evaluation and Management of the Acute Abdomen