Gastric Outlet Obstuction

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GASTRIC OUTLET OBSTRUCTION

Gastric outlet obstruction is a medical emergency, which may an indication of Gastric carcinoma. Vomiting and pain will be the most common presenting symptoms in patients. An accurate diagnosis can prove much useful in these persons. This condition is a very common complication of long term peptic ulcers

An ulcer in the region of the pylorus may result in gastric outlet

obstruction. This may be due to fibrous stricture or to oedema or spasm

produced by the ulcer frequently it is a combination of all three. Long

standing obstruction may lead to severe retention gastritis or even to

secondary gastric ulcer.

In addition to chronic duodenal ulcer or benign gastric ulcer at or

near the pylorus, gastric outlet obstruction may be caused by carcinoma of

the antrum and by a rare condition known as adult hypertrophic polyric

stenoisis.

The syndrome of gastric outlet obstruction if loosely described as

“pyloric stenosis”. Even when the cause if chronic duodenal ulcer and

the stenosis is distal to the pylorus, thus in ‘pyloric’ obstruction due to

duodenal stenosis, the pylorus itself may be seen radiologically to be

greatly dilated.

Clinical features

Symptoms obstruction are usually proceeded by a long history of

duodenal ulceration without such symptoms, a patient with gastric outlet

obstruction is likely to have a phyloric carcinoma. When there has been an

ulcer, the symptoms change so that vomiting becomes a prominent feature

and nausea replaced normal appetite. Vomiting produces such stringing

relief that a patient may start to eat immediately after the stomach has

been emptied. If the obstruction progresses the stomach dilates so that

eventually, surprisingly large, amounts of gastric content may be vomited.

Articles of flood which have been eaten 24 hours or more previously may

be recognized in vomit. An earlier symptom is a sense of repletion soon

after eating a relatively small amount of food. The loss of gastric contents

results in water and electrolyte depletion. The blood urea may be raised

because of dehydration. Alkalosis develops if large amounts of

hydrochloric acid are lost, as occurs particularly in obstruction due to

duodenal ulcer.

Seek medical attention at the earliest if these symptoms prevail.

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