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Gastric Outlet Obstruction

Gastric Outlet Obstruction is a topic covered in the 5-Minute Emergency Consult.

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  • 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
  • Benign and malignant causes, including:
    • Neoplasms (most common cause in adults), intrinsic or extrinsic neoplasms (pancreatic, gastric lymphoma, duodenal, gallbladder). Extrinsic masses may cause 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)


  • 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

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Rosen, Peter, et al., editors. "Gastric Outlet Obstruction." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307406/all/Gastric_Outlet_Obstruction.
Gastric Outlet Obstruction. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307406/all/Gastric_Outlet_Obstruction. Accessed June 18, 2019.
Gastric Outlet Obstruction. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307406/all/Gastric_Outlet_Obstruction
Gastric Outlet Obstruction [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 June 18]. 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 - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, 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 - 5 DB - Emergency Central DP - Unbound Medicine ER -