Gastric outlet obstruction (Complication)

mechanical obstruction of the distal stomach, pyloric channel, or duodenum

• Malignancy (most common)

  • Intrinsic lumen reduction: gastric or duodenal cancer

  • Extrinsic compression: pancreatic or biliary malignancy, lymphoma

• Peptic ulcer disease (PUD)

• Other: gastric volvulus, strictures , foreign bodies

• Postprandial, nonbilious vomiting

• Early satiety

• Weight loss

• Progressive abdominal dilation

• Succussion splash: a splashing sound created by the movement of gastric contents

  • Physiological if present immediately after a meal

  • Pathological if present after ≥ 3 hours of fasting

• UGI series

• CT or MRI abdomen

• EGD (confirmatory)

• Laboratory studies (supportive): hypokalemic hypochloremic metabolic alkalosis

• Saline load test

• Treat the underlying cause (e.g., H. pylori eradication).

• Relieve the obstruction.

  • Endoscopic stent placement

  • Surgical options: gastrectomy, gastrojejunostomy