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]
Abstract A case of massive hydrops of the gallbladder producing pyloric obstruction in a seven year old boy is presented. [pediatrics.aappublications.org]
Entire Body System
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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]
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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]
Later work reinforced the association between malnutrition and poor surgical outcome [3,4]. [omicsonline.org]
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]
Malnutrition is a ... [accesssurgery.mhmedical.com]
Malignant gastric outlet obstruction can go unrecognized until severe malnutrition has already been established. [healio.com]
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Hypoxemia
61 Solitary Pulmonary Nodule in a 58YearOld Male Case 42 483 Chapter 62 Persistent Jaundice in a 1MonthOld Infant Case 43 497 Chapter 63 Newborn Baby with a Large Abdominal Wall Defect Case 44 503 Chapter 64 Newborn Infant with Labored Breathing and Hypoxemia [books.google.com]
Gastrointestinal
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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]
[…] 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 67 4YearOld Boy with a Groin Mass Case 48 529 Chapter 68 2YearOld Boy with Gastrointestinal Bleeding Case 49 537 [books.google.com]
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]
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Nausea
Patients usually present with progressive nausea, vomiting of residual food, abdominal distension and sometimes abdominal pain. [omicsonline.org]
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]
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]
The patient had mild recurrence of nausea 2.5 weeks following the stent placement. [acgcasereports.gi.org]
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Abdominal Pain
Pain Vomiting and Fever of 385C Case 47 523 Chapter 67 4YearOld Boy with a Groin Mass Case 48 529 Chapter 68 2YearOld Boy with Gastrointestinal Bleeding Case 49 537 Chapter 69 Abdominal Mass in a 4MonthOld Infant Case 50 545 Chapter 70 Liver Transplant [books.google.com]
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]
Patients usually present with progressive nausea, vomiting of residual food, abdominal distension and sometimes abdominal pain. [omicsonline.org]
Acquired double pylorus typically present symptomatic with chronic upper abdominal pain, vomiting, dyspepsia, or upper gastrointestinal bleeding. [scholarlycommons.hcahealthcare.com]
The most frequent symptoms of phytobezoars in the stomach are dyspepsia, abdominal pain and vomiting or nausea. [academic.oup.com]
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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]
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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
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Hyponatremia
Hyponatremia 2. Hypokalemia 3. Hypomagnesemia 4. Hypochloraemia 5. Metabolic alkalosis 6. [slideshare.net]
Other Pathologies
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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]
Therefore, to remove gastric bezoar promptly, surgical treatment was suggested. 3D laparoscopic was suggested for the following advantages. [alliedacademies.org]
In spite of steroid and proton pump inhibitor treatment, her symptoms did not improve. [synapse.koreamed.org]
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
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]
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]
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]
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]
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]
He is concerned of this because the long duration of pump feeding prevents him from a social life. [omicsonline.org]
For example, it can help your healthcare provider prevent complications due to a drug interaction If you are allergic to any specific medication or food items If you are taking blood thinners, such as aspirin, warfarin, herbal supplements, or any other [dovemed.com]
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]
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]