Gastric Outlet Obstruction
Basics
Description
Description
- 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 and nonbilious vomiting
- 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
Etiology
Etiology
- Neoplasms (most common cause in adults)
- Intrinsic or extrinsic neoplasms (pancreatic, gastric lymphoma, duodenal, gallbladder) causing compression at pylorus or proximal duodenum
- Peptic ulcer disease (PUD), no longer most common cause in adults, with treatment of Helicobacter pylori and use of H2 blockers
- Pyloric stenosis (most common pediatric cause): Incidence 2–5/1,000
- Postoperative complications, especially from gastric surgeries (e.g., edema, scarring, stricture, or hyperplasia of pylorus or duodenum)
- Mechanical causes: Gastric volvulus, polyps, bezoars, duplication cysts
- Edema, scarring, strictures/webs, or hyperplasia of pylorus or duodenum from various causes (e.g., caustic injury, chronic pancreatitis)
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Citation
Schaider, Jeffrey J., et al., editors. "Gastric Outlet Obstruction." 5-Minute Emergency Consult, 6th ed., Lippincott Williams & Wilkins, 2020. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307406/all/Gastric_Outlet_Obstruction.
Gastric Outlet Obstruction. In: Schaider JJJ, Barkin RMR, Hayden SRS, et al, eds. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307406/all/Gastric_Outlet_Obstruction. Accessed November 8, 2024.
Gastric Outlet Obstruction. (2020). In Schaider, J. J., Barkin, R. M., Hayden, S. R., Wolfe, R. E., Barkin, A. Z., Shayne, P., & Rosen, P. (Eds.), 5-Minute Emergency Consult (6th ed.). Lippincott Williams & Wilkins. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307406/all/Gastric_Outlet_Obstruction
Gastric Outlet Obstruction [Internet]. In: Schaider JJJ, Barkin RMR, Hayden SRS, Wolfe RER, Barkin AZA, Shayne PP, Rosen PP, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2020. [cited 2024 November 08]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307406/all/Gastric_Outlet_Obstruction.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC
T1 - Gastric Outlet Obstruction
ID - 307406
ED - Barkin,Adam Z,
ED - Shayne,Philip,
ED - Rosen,Peter,
ED - Schaider,Jeffrey J,
ED - Barkin,Roger M,
ED - Hayden,Stephen R,
ED - Wolfe,Richard E,
BT - 5-Minute Emergency Consult
UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307406/all/Gastric_Outlet_Obstruction
PB - Lippincott Williams & Wilkins
ET - 6
DB - Emergency Central
DP - Unbound Medicine
ER -