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    Gastric Outlet Obstruction

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    Gish Kioi
    Gastric outlet obstruction is caused by mechanical obstruction of the pyloric channel, most commonly due to gastric cancer or peptic ulcer disease. Patients present with early satiety, weight loss, and projectile vomiting of undigested food. Diagnosis involves blood tests showing electrolyte abnormalities, imaging like CT or barium swallow showing an enlarged stomach and narrowing of the bowel, and endoscopy to identify the cause. Treatment consists of fluid resuscitation, nasogastric suction, and parenteral nutrition for symptom relief along with definitive procedures like gastroenterostomy or endoscopic balloon dilation to bypass the obstruction.

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    Gastric Outlet Obstruction

    Uploaded by

    Gish Kioi
    30 views7 pages
    Gastric outlet obstruction is caused by mechanical obstruction of the pyloric channel, most commonly due to gastric cancer or peptic ulcer disease. Patients present with early satiety, weight loss, and projectile vomiting of undigested food. Diagnosis involves blood tests showing electrolyte abnormalities, imaging like CT or barium swallow showing an enlarged stomach and narrowing of the bowel, and endoscopy to identify the cause. Treatment consists of fluid resuscitation, nasogastric suction, and parenteral nutrition for symptom relief along with definitive procedures like gastroenterostomy or endoscopic balloon dilation to bypass the obstruction.

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    Gastric outlet obstruction is caused by mechanical obstruction of the pyloric channel, most commonly due to gastric cancer or peptic ulcer disease. Patients present with early satiety, weight loss, and projectile vomiting of undigested food. Diagnosis involves blood tests showing electrolyte abnormalities, imaging like CT or barium swallow showing an enlarged stomach and narrowing of the bowel, and endoscopy to identify the cause. Treatment consists of fluid resuscitation, nasogastric suction, and parenteral nutrition for symptom relief along with definitive procedures like gastroenterostomy or endoscopic balloon dilation to bypass the obstruction.

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    30 views7 pages

    Gastric Outlet Obstruction

    Uploaded by

    Gish Kioi
    Gastric outlet obstruction is caused by mechanical obstruction of the pyloric channel, most commonly due to gastric cancer or peptic ulcer disease. Patients present with early satiety, weight loss, and projectile vomiting of undigested food. Diagnosis involves blood tests showing electrolyte abnormalities, imaging like CT or barium swallow showing an enlarged stomach and narrowing of the bowel, and endoscopy to identify the cause. Treatment consists of fluid resuscitation, nasogastric suction, and parenteral nutrition for symptom relief along with definitive procedures like gastroenterostomy or endoscopic balloon dilation to bypass the obstruction.

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    © All Rights Reserved
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    Gastric Outlet Obstruction

    • Mechanical obstruction of the pyloric channel.


    Etiology:
    1. Gastric cancer- most common cause
    2. PUD
    Acute PUD → inflammation and edema
    Chronic PUD → scarring and fibrosis
    3. Gastric volvulus
    4. Crohn disease- causes strictures at the pylorus
    5. Chronic pancreatitis- causes strictures at the pylorus
    Clinical Features
    • General: Early satiety, weight loss, dehydrated
    • Vomitus: Postprandial, nonbilious, projectile vomiting. Possible to
    recognise foodstuff taken previously.
    • Physical Examination:
    -Progressive abdominal dilation
    -Succussion splash positive
    Diagnosis
    1. UECs
    Hypokalemia
    Hypochloraemia
    Hypocalcemia
    Hyponatremia
    Metabolic alkalosis: ↓Biocarbonate ↑ Hydrogen ions
    2. Abdominal CT scan
    3. OGD (upper endocscopy) and Biopsy around the pylorus to r/o malignancy
    4. Barium swallow
    -Enlarged stomach
    -String Sign: narrowing of loop of bowel
    5. Saline Load Test
    750 ml of saline injected into the patients nasogastric tube on an empty
    stomach. If the aspirate is more than 400 ml after 30 minutes, GOO is present.
    Management
    A. Symptomatic
    -Electrolyte and fluid replacement with IV isotonic saline with
    potassium supplementation

    -Nasogastric suction until stomach empty. This allows investigation of


    patient with endoscopy and contrast radiology.

    - Parenteral nutrition
    B. Definitive
    1. Gastroenterostomy
    Surgical creation of a connection between the stomach and the
    jejunum.

    2. Endoscopic balloon dilation

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