gastric outlet obstruction (pyloric stenosis)

Etiology

• peptic ulcers situated close to the pyloric channel
• advanced gastrointestinal cancer
  • gastric cancer, duodenal cancer, or pancreatic cancer
• also see hypertrophic pyloric stenosis

Epidemiology

• 5% of patient with peptic ulcer

Clinical manifestations

• nausea/vomiting

Laboratory

• hypokalemia may occur
• metabolic alkalosis may be present
• evidence of dehydration may be present

Radiology

in

• plain abdominal film often shows dilated stomach with air- fluid level

Management

• nasogastric suction for at least 72 hr to decompress the stomach
• hydrate
• correct hypokalemia
• endoscopic dilatation
  • endoscopically placed stainless steel stents can palliate obstructive symptoms, failure is frequent due to migration or obstruction
  • newer nickel titanium (nitinol) self-expandable stent placed through the endoscope channel under fluoroscopic guidance may be of benefit
• surgical correction

More general terms

• gastric disease

More specific terms

• hypertrophic pyloric stenosis (IHPS, HPS)