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Pyloric Obstruction


Presentation

  • We report the case of a 2-day-old female neonate presenting with neonatal cholestasis, nonbilious vomiting with pyloric obstruction, and multiple intestinal atresias.[ncbi.nlm.nih.gov]
  • A case of pyloric obstruction caused by ingestion of enteric-coated aspirin tablets is presented. The patient was predisposed by previous pyloric stenosis. A barium meal study was diagnostic.[ncbi.nlm.nih.gov]
  • We report a case of adult pyloric obstruction caused by the delayed presentation of a congenital gastric diverticulum. The derivation, classification and treatment of these abnormalities are discussed.[ncbi.nlm.nih.gov]
  • Abstract A 16-month-old dog was presented with chronic vomiting, anorexia, progressive weight loss, and melena.[ncbi.nlm.nih.gov]
  • Abstract A case of massive hydrops of the gallbladder producing pyloric obstruction in a seven year old boy is presented.[pediatrics.aappublications.org]
Weight Loss
  • Abstract A 16-month-old dog was presented with chronic vomiting, anorexia, progressive weight loss, and melena.[ncbi.nlm.nih.gov]
  • Patients with GOO can present with nausea, post-prandial vomiting, early satiety, dehydration, abdominal bloating, weight loss, and epigastric tenderness.[cancertherapyadvisor.com]
  • Maldigestion and steatorrhea caused by pancreaticobiliary bypass, especially with Billroth II anastomosis, may contribute to weight loss.[merckmanuals.com]
  • You should see a doctor if you have any of the following: Blood when you have a bowel movement Severe abdominal pain Heartburn not relieved by antacids Unintended weight loss Ongoing vomiting or diarrhea NIH: National Institute of Diabetes and Digestive[icdlist.com]
Malnutrition
  • Physical examination often demonstrates the presence of chronic dehydration and malnutrition. A dilated stomach may be appreciated as a tympanitic mass in the epigastric area and/or left upper quadrant.[thehealthscience.com]
  • Malignant gastric outlet obstruction can go unrecognized until severe malnutrition has already been established.[healio.com]
  • Physical examination reveals the presence of chronic dehydration and malnutrition. A dilated stomach may be appreciated as a tympanitic mass in the epigastric area.[ispub.com]
  • Physical examination often demonstrates the presence of chronic dehydration and malnutrition. A dilated stomach may be appreciated as a tympanic mass in the epigastric area and/or left upper quadrant.[laparoscopyhospital.com]
  • […] radiography, contrast enema, ultrasonography, and computed tomography (CT) scan can demonstrate the presence of intramural gastrointestinal gas. [1], [4] Case Report A 66-year-old male presented to the emergency with nausea, vomiting, an abdominal pain, and malnutrition[ccij-online.org]
Vomiting
  • We report the case of a 2-day-old female neonate presenting with neonatal cholestasis, nonbilious vomiting with pyloric obstruction, and multiple intestinal atresias.[ncbi.nlm.nih.gov]
  • Abstract A 16-month-old dog was presented with chronic vomiting, anorexia, progressive weight loss, and melena.[ncbi.nlm.nih.gov]
  • The condition can progress to descompensated phases in which food does not reach the duodenum with resulting vomiting.[olgatorresfoundation.org]
  • Vomiting becomes inevitable if the contents of the stomach are unable to find their way through the pylorus, the furthest part of the stomach that opens in intestine immediately beyond the stomach, the duodenum.[childhealth-explanation.com]
  • After the operation, vomiting was relieved. Then, she was discharged and she did not relapse during the follow-up period.[synapse.koreamed.org]
Nausea
  • Associated symptoms included epigastric swelling pain, nausea and vomiting. The pain was relieved after vomiting. The patient treated it as stomach disorders, which proved to be ineffective. The symptoms got worse nine days prior to admission.[alliedacademies.org]
  • Patients with GOO can present with nausea, post-prandial vomiting, early satiety, dehydration, abdominal bloating, weight loss, and epigastric tenderness.[cancertherapyadvisor.com]
  • No matter the cause, clinical presentation usually involves vomiting, nausea, malnutrition, dehydration, and associated electrolyte abnormalities.[healio.com]
  • Presentation Nausea and vomiting are the cardinal symptoms of gastric outlet obstruction. Vomiting usually is described as nonbilious, and it characteristically contains undigested food particles.[thehealthscience.com]
Abdominal Pain
  • You should see a doctor if you have any of the following: Blood when you have a bowel movement Severe abdominal pain Heartburn not relieved by antacids Unintended weight loss Ongoing vomiting or diarrhea NIH: National Institute of Diabetes and Digestive[icdlist.com]
  • Presenting symptoms and signs were nonbilious vomiting, weight loss, dehydration, dyselectrolytemia, abdominal pain, and visible gastric peristalsis. Upper gastrointestinal contrast study showed large stomach and increased gastric emptying time.[ncbi.nlm.nih.gov]
  • Common gastrointestinal symptoms experienced by patients with cancer can vary widely and include nausea, vomiting, diarrhea, constipation, weight loss, decreased appetite, and abdominal pain.[cancertherapyadvisor.com]
  • Symptoms associated with it are nonspecific, commonly including abdominal pain and distension, diarrhea, bloody stool, and constipation.[ccij-online.org]
  • Abdominal pain is not frequent and usually relates to the underlying cause, eg, PUD, pancreatic cancer. Physical examination often demonstrates the presence of chronic dehydration and malnutrition.[thehealthscience.com]
Early Satiety
  • Patients with GOO can present with nausea, post-prandial vomiting, early satiety, dehydration, abdominal bloating, weight loss, and epigastric tenderness.[cancertherapyadvisor.com]
  • Patients with gastric outlet obstruction resulting from a duodenal ulcer or incomplete obstruction typically present with symptoms of gastric retention, including early satiety, bloating or epigastric fullness, indigestion, anorexia, nausea, vomiting,[thehealthscience.com]
  • Epigastric fullness and early satiety are common. Physical examination reveals the presence of chronic dehydration and malnutrition. A dilated stomach may be appreciated as a tympanitic mass in the epigastric area.[ispub.com]
  • Weight loss is common after subtotal gastrectomy; the patient may limit food intake because of early satiety (because the residual gastric pouch is small) or to prevent dumping syndrome and other postprandial syndromes.[merckmanuals.com]
  • Early satiety and epigastric fullness are common. Weight loss is frequent when the condition approaches chronicity and is most significant in patients with malignant disease.[laparoscopyhospital.com]
Persistent Vomiting
  • Persistent vomiting can quickly lead to dehydration and electrolyte imbalance, which can be life-threatening. Babies will fail to gain weight (or will lose weight). They may also become irritable and weak if this condition is not corrected.[health.state.mn.us]
  • Patient had complaints of persistent vomiting with significant weight loss.[bhj.org.in]
  • INTRODUCTION Gastric outlet obstruction in the pediatric population, after the first few weeks of life, is an uncommon cause of persistent vomiting and most often requires surgical interventions.[chw.org]
  • Patients may develop significant and progressive gastric dilatation if obstruction persists. Vomiting usually is non-bilious. Weight loss is frequent. Epigastric fullness and early satiety are common.[ispub.com]

Workup

  • She was admitted to another hospital for further workup.[chw.org]
  • As part of the initial workup, exclude the possibility of functional nonmechanical causes of obstruction, such as diabetic gastroparesis.[thehealthscience.com]
Multiple Ulcerations
  • Gastrin-secreting cancer and gastrinoma should be considered when there are multiple ulcers, when ulcers develop in atypical locations (eg, postbulbar) or are refractory to treatment, or when the patient has prominent diarrhea or weight loss.[merckmanuals.com]
Intranuclear Inclusion Bodies
  • On the 8th day, according to her pathologic report, crypt abscess and inflammatory cell infiltration were found in the colonic mucosa, consistent with ulcerative colitis, and eosinophilic intranuclear inclusion body with acute inflammatory change was[synapse.koreamed.org]

Treatment

  • CONCLUSION: Despite the small number in this study, partially covered SEMSs showed a favorable and safe outcome in the treatment of naïve benign pyloric obstruction and in salvage treatment after balloon dilatation failure.[ncbi.nlm.nih.gov]
  • The derivation, classification and treatment of these abnormalities are discussed.[ncbi.nlm.nih.gov]
  • The treatment, in addition to the usual gastric decompression and fluid and electrolyte replacement therapy, was effective in 10 patients (83.4 percent). In eight of these patients the results of the trial was regarded as "very good".[ncbi.nlm.nih.gov]
  • Review the latest developments in the field and get up-to-date clinical information on hot topics like polyps, capsule endoscopy, and pancreatic treatments.[books.google.com]
  • In spite of steroid and proton pump inhibitor treatment, her symptoms did not improve.[synapse.koreamed.org]

Prognosis

  • In patients with largely metastatic disease, determine the degree of surgical intervention for palliation in light of the patient's realistic prognosis and personal wishes.[thehealthscience.com]
  • In the rare cases when surgery cannot be done, prognosis is poor. Obstruction may be caused by scarring, spasm, or inflammation from an ulcer.[merckmanuals.com]
  • The prognosis of gastric outlet obstruction. Ann Surg. 1985;201(2):176-9. 8. Khullar SK, DiSario JA. Gastric outlet obstruction. Gastrointest Endosc Clin N Am. 1996;6:585-603. 9. Kurtz RC, Sherlock P. Carcinoma of the stomach.[ispub.com]

Etiology

  • GOO has both benign and malignant etiologies, however the history and physical exam findings are similar.[cancertherapyadvisor.com]
  • Aims: A retrospective analysis of the endoscopic findings of patients presenting with features of GOO to determine the demographic and etiological patterns.[najms.org]
  • However, a wide range of other etiologies may lead to a similar set of symptoms. Parkinsonism can be caused by drugs, toxins and metabolic diseases.[austinpublishinggroup.com]
  • Pathology Etiology Gastric outlet obstruction can be due to malignant or benign causes.[radiopaedia.org]

Epidemiology

  • Woven throughout the content is new and updated material that reflects key practice differences in Canada, ranging from the healthcare system, to cultural considerations, epidemiology, pharmacology, Web resources, and more.[books.google.com]
  • METHODS: Eight patients of this disease presented at our center from 1996 to May 2008, and these were analyzed epidemiologically and clinically. Other reports published in literature were compared, and all reported patients were compiled.[ncbi.nlm.nih.gov]
  • Epidemiology Frequency The incidence of gastric outlet obstruction (GOO) has been reported to be less than 5% in patients with PUD, which is the leading benign cause of the problem.[thehealthscience.com]
  • Gastric cancer epidemiology and risk factors. J Clin Epidemiol. 2003;56(1):1-9. 2. Jeurnink SM, van Eijck CH, Steyerberg EW, et al. Stent versus gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review.[healio.com]
Sex distribution
Age distribution

Pathophysiology

  • The pathophysiology of gastrointestinal ulcer by CMV infection is believe to be associated with the invasion of the endothelium of the vessels in the submucosa and causes vasculitis.[synapse.koreamed.org]
  • Gastric Outlet Obstruction Pathophysiology Scarring, stricture, or hyperplasia at pylorus or duodenum Intrinsic or extrinsic mass causing compression at pylorus or proximal duodenum Pyloric stenosis is most common cause in pediatric population Can be[fprmed.com]
  • Pathophysiology Intrinsic or extrinsic obstruction of the pyloric channel or duodenum is the usual pathophysiology of gastric outlet obstruction; as previously noted, the mechanism of obstruction depends upon the underlying etiology.[thehealthscience.com]
  • Malignant Tumours of the stomach, including adenocarcinoma (and its linitis plastica variant), lymphoma, and gastrointestinal stromal tumours Pathophysiology [ edit ] In a peptic ulcer it is believed to be a result of edema and scarring of the ulcer,[en.wikipedia.org]
  • Pathophysiology Intrinsic or extrinsic obstruction of the pyloric channel or duodenum is the usual pathophysiology of GOO; as previously noted, the mechanism of obstruction depends upon the underlying etiology.[laparoscopyhospital.com]

Prevention

  • This may markedly reduce the need for emergency operation and prevent many postoperative complications which not uncommonly follow emergency surgery for pyloric stenosis.[ncbi.nlm.nih.gov]
  • Therefore, to prevent gastric outlet obstruction, it would be better to place a temporary stent in the pylorus before starting any anti-viral and anti-ulcer medications. 9 In our case, temporary stent insertion was not possible due to complete obstruction[synapse.koreamed.org]
  • Therefore, appropriate and prompt diagnosis is important in order to prevent the development of potentially severe complications [ 2 , 3 ].[alliedacademies.org]
  • Oversew the area with a continuous suture to prevent a postoperative leak. No drainage procedure is required. E. Complications 1.[laparoscopyhospital.com]
  • If adhesions prevent leakage into the peritoneal cavity, free penetration is avoided and confined perforation occurs.[merckmanuals.com]

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