Gastric outlet obstruction
| Gastric outlet obstruction | |
|---|---|
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| Decubitus x-ray of abdomen of patient with gastric outlet obstruction. There is a prominent gastric air bubble, gastric air-fluid level, and a dilated stomach with particulate matter within it. | |
| Classification and external resources | |
| Specialty | gastroenterology |
| ICD-10 | K31.1 |
| ICD-9-CM | 537.0 |
| eMedicine | article/190621 |
Gastric outlet obstruction (often abbreviated as GOO) is a medical condition where there is an obstruction at the level of the pylorus, which is the outlet of the stomach. Individuals with gastric outlet obstruction will often have recurrent vomiting of food that has accumulated in the stomach, but which cannot pass into the small intestine due to the obstruction. The stomach often dilates to accommodate food intake and secretions. Causes of gastric outlet obstruction include both benign causes (such as peptic ulcer disease affecting the area around the pylorus), as well as malignant causes, such as gastric cancer.
Causation related to ulcers may involve severe pain which the patient may interpret as a heart condition/attack.
Treatment of the condition depends upon the underlying cause; it can involve antibiotic treatment when H. Pylori is related to an ulcer,endoscopic therapies (such as dilation of the obstruction with balloons or the placement of self expandable metallic stents), other medical therapies, or surgery to resolve the obstruction.
The causes are divided into benign or malignant.
In a peptic ulcer it is believed to be a result of edema and scarring of the ulcer, followed by healing and fibrosis, which leads to obstruction of the gastroduodenal junction (usually an ulcer in the first part of the duodenum).
The main symptom is vomiting, which typically occurs after meals of undigested food, devoid of any bile. A history of previous peptic ulcers and loss of weight is not uncommon. In advanced cases, signs to look for on physical examination are wasting and dehydration. Visible Peristalsis from left to right may be present. Succussion splash is a splash-like sound heard over the stomach in the left upper quadrant of the abdomen on shaking the patient, with or without the stethoscope. Bowel sound may be increased due to excessive peristaltic action of stomach. Fullness in left hypochondrium may also be present.
The most confirmatory investigation is endoscopy of upper gastrointestinal tract.
Laboratory
Abdominal X-ray
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