Nothing Special   »   [go: up one dir, main page]

Gastric Outlet Obstruction (Stenosis) : Lior Shlomov 1852

Download as pptx, pdf, or txt
Download as pptx, pdf, or txt
You are on page 1of 8

Gastric outlet obstruction

(stenosis)
Lior Shlomov
1852
 Gastric outlet obstruction (GOO, also known as pyloric obstruction) is not a
single entity
 It is the clinical and pathophysiological consequence of any disease process
that produces a mechanical obstruction to gastric emptying.
 Clinical entities that can result in GOO generally are categorized into two
well-defined groups of causes: benign and malignant.
Etiology-

 Benign causes are –


1) Peptic ulcer disease
2) Gastric polyps
3) Hypertrophic Pyloric stenosis
4) Congenital duodenal web
5) Pancreatic pseudocyst
 Malignant causes-
1) Pancreatic carcinoma
2) Gastric adenocarcinoma
3) Ampullary cancer
4) Duodenal cancer
Symptoms-

 Frequent vomiting (1 hour after a meal)


 Retention, bloating and epigastric fullness.
 Epigastric pain
 Weight loss
Diagnosis-

 Physical examination – severe dehydration and malnutrition , may be


tympanic mass over epigastric area.
*succussion splash sign - splash-like sound heard over the stomach in the left
upper quadrant of the abdomen on shaking the patient.
 Laboratory examination – hypochromic, hypokalemic metabolic alkalosis.
 Abdominal X-ray may show a gastric fluid level which would support the
diagnosis.
 The most confirmatory investigation is endoscopy of upper gastrointestinal
trac
Treatment

 Depends on the cause, but is usually either surgical or medical.


 Medical (if its reversible)
 Endoscopic balloon dilation therapy
 Surgical-
Antrectomy ( removal of the antral portion of the stomach)
vagotomy
Billroth I

You might also like