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2.1
Pyloric Obstruction
Obstruction Pyloric

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]

Case Presentation A 59-year-old female presented with symptoms suggestive of gastric outlet obstruction with a background of long-standing dyspepsia. [hindawi.com]

However, in the present case, no clinical features of immunodeficiency were observed and HIV status being negative. The present case presented with gastric outlet obstruction which clinically and endoscopically mimicked gastric carcinoma. [jmedscindmc.com]

Entire Body System

  • Weight Loss

    Abstract A 16-month-old dog was presented with chronic vomiting, anorexia, progressive weight loss, and melena. [ncbi.nlm.nih.gov]

    Besides these direct results of pyloric obstruction, prolonged GI disorder often results in reduced intake of food and rapid weight loss. [omicsonline.org]

    Other commonly seen symptoms include early satiety, abdominal distention, and weight loss.7 Initially, patients have intermittent symptoms that then progress until the obstruction is complete. Malnutrition is a ... [accesssurgery.mhmedical.com]

    loss, malnutrition, failure to thrive Hypokalemic, hypochloremic metabolic alkalosis is classic finding Neoplasms (most common cause in adults) Intrinsic or extrinsic neoplasms (pancreatic, gastric lymphoma, duodenal, gallbladder) causing compression [emergency.unboundmedicine.com]

  • Malnutrition

    […] in origin Regardless of exact cause, gastric outlet obstruction characteristically leads to nausea and nonbilious vomiting Persistent vomiting may lead to dehydration, electrolyte and acid–base derangements: Chronic symptoms may lead to weight loss, malnutrition [emergency.unboundmedicine.com]

    Malnutrition is a ... [accesssurgery.mhmedical.com]

    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]

Gastrointestinal

  • Vomiting

    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]

    Nausea and non-bilious vomiting are the characteristic symptoms [2]. [scitechnol.com]

    Persistent vomiting may lead to dehydration, electrolyte and acid–base derangements: Chronic symptoms may lead to weight loss, malnutrition, failure to thrive Hypokalemic, hypochloremic metabolic alkalosis is classic finding Neoplasms (most common cause [emergency.unboundmedicine.com]

    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]

    Vomiting is the cardinal symptom. Malnutrition is a late sign. Our patient had vomiting for about two months and he was emaciated. Prolonged vomiting may lead to dehydration and electrolyte abnormalities. [ispub.com]

  • Nausea

    The patient had mild recurrence of nausea 2.5 weeks following the stent placement. [acgcasereports.gi.org]

    Basics Any process impeding the passage of gastric contents into the duodenum Causes not limited to gastric pathology and may be duodenal or extraluminal in origin Regardless of exact cause, gastric outlet obstruction characteristically leads to nausea [emergency.unboundmedicine.com]

    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]

  • Abdominal Pain

    New York Presbyterian Queens Introduction: Gastric outlet obstruction (GOO) is a blockage in the outflow of the stomach that is characterized by abdominal pain and postprandial emesis of undigested food. [sages.org]

    Acquired double pylorus typically present symptomatic with chronic upper abdominal pain, vomiting, dyspepsia, or upper gastrointestinal bleeding. [scholarlycommons.hcahealthcare.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]

    The most frequent symptoms of phytobezoars in the stomach are dyspepsia, abdominal pain and vomiting or nausea. [academic.oup.com]

    Wall Defect Case 44 503 Chapter 64 Newborn Infant with Labored Breathing and Hypoxemia Case 45 510 Chapter 65 Vomiting in an Infant Case 46 516 Chapter 66 3YearOld Female with a 12Hour Onset of Abdominal Pain Vomiting and Fever of 385C Case 47 523 Chapter [books.google.com]

  • Early Satiety

    Other commonly seen symptoms include early satiety, abdominal distention, and weight loss.7 Initially, patients have intermittent symptoms that then progress until the obstruction is complete. Malnutrition is a ... [accesssurgery.mhmedical.com]

    She noted early satiety, a 15 lbs weight loss (last 3 months) and constipation. Examination revealed a malnourished woman with temporal and supraclavicular wasting. [imagejournals.org]

    Patient described three month of abdominal discomfort, early satiety, regurgitation of food, and 10 pounds weight loss, with recent development of abdominal distention. [journals.lww.com]

    Patients with GOO can present with nausea, post-prandial vomiting, early satiety, dehydration, abdominal bloating, weight loss, and epigastric tenderness. [cancertherapyadvisor.com]

  • Recurrent Vomiting

    With a congenital pseudo-pyloric stricture that occurred proximal to the original pylorus, he was suffering from recurrent vomiting, epigastric pain and growth retardation. [clinicsinsurgery.com]

    Case Reports Case 1 A 50-year-old female presented with history of epigastric pain, recurrent vomiting and significant weight loss since 4 months. [jdeonline.in]

    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. [en.wikipedia.org]

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]

WORKUP Laboratory Studies • Obtain a CBC. Check the hemoglobin and hematocrit to. rule out the possibility of anemia. • Obtain an electrolyte panel. [slideshare.net]

Serum

  • Hyponatremia

    Hyponatremia 2. Hypokalemia 3. Hypomagnesemia 4. Hypochloraemia 5. Metabolic alkalosis 6. [slideshare.net]

Treatment

Thus, evaluation of these diseases is mandatory before planning treatment. [hindawi.com]

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]

In pediatric patients, the technique of EBD treatment in esophageal stricture is relatively more mature than EBD treatment in pyloric stricture. [wjgnet.com]

Therefore, to remove gastric bezoar promptly, surgical treatment was suggested. 3D laparoscopic was suggested for the following advantages. [alliedacademies.org]

Conservative treatment including PPI should be first line therapy for the gastric outlet obstruction due to peptic ulcer in children. Surgical treatment should be reserved for the patients with failed medical treatment. [nature.com]

Prognosis

The procedure was rarely performed until the 1980s because of the high operative morbidity, mortality, and poor prognosis associated with periampullary malignancies. [jhu.pure.elsevier.com]

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]

[…] stomach may be herniated (type IV paraesophageal hernia (PEH)) or only part of it (type III PEH) both can result in volvulus obstruction ischemia ischemia seen as lack of contrast enhancement of gastric wall, with or without pneumatosis Treatment and prognosis [radiopaedia.org]

[…] depends upon the patient's particular circumstances • In cases of malignant obstruction, weigh the extent of surgical intervention for the relief of obstruction against the malignancy's type and extent, as well as the patient's anticipated long-term prognosis [slideshare.net]

Etiology

Another less common etiology is a bezoar. [sages.org]

Aims: A retrospective analysis of the endoscopic findings of patients presenting with features of GOO to determine the demographic and etiological patterns. [najms.org]

The purpose of this study is to review the etiology, clinical manifestations, treatment and outcome of the patients in two tertiary referral centers. [nature.com]

GOO has both benign and malignant etiologies, however the history and physical exam findings are similar. [cancertherapyadvisor.com]

Epidemiology

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]

Biochemistry (17) Histology, Embryology (15) Obstetrics, Gynaecology (14) Endocrinology, Metabolism (13) General Practice Medicine (13) Microbiology (12) Anaesthesiology and Intensive Care Medicine (12) Nuclear Medicine (11) Haematology (10) Urology (10) Epidemiology [portal.mefanet.cz]

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]

Epidemiology of extrapulmonary tuberculosis. A comparative analysis with pre-AIDS era. Chest 1991;99:1134-8. 7. Khan FY, AlAni A, Al-Rikabi A, Mizrakhshi A, Osman Mel-M. [jmedscindmc.com]

Pathophysiology

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]

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]

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 impediment to gastric emptying. [medicalstudentcheater.blogspot.com]

Free Gastric outlet obstruction (GOO) is the clinical and pathophysiological manifestation of any disease process that produces a mechanical impediment to gastric emptying. [journals.lww.com]

Pathophysiology 5. Clinical features 6. Physical examinations 7. Metabolic effects 8. Investigations 9. Management (conservative and surgical along with indications) 10. [slideshare.net]

Prevention

He is concerned of this because the long duration of pump feeding prevents him from a social life. [omicsonline.org]

In order to prevent closure of the gastrostomy, a Foley catheter was immediately put in place. Several hours later the patient presented with vomiting. [revistagastroenterologiamexico.org]

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]

Oversew the area with a continuous suture to prevent a postoperative leak. No drainage procedure is required. E. Complications 1. [laparoscopyhospital.com]

However, treatment is suggested for larger tumors, even if asymptomatic, to prevent development of complications such as bleeding or obstruction. [karger.com]

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2.1
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