Flashcards in Gastric Outlet Obstruction Deck (7):
What is Gastric Outlet obstruction
The obstruction of the gastric outlet (at the level of the pyloric sphincter)
What are the causes of gastric outlet obstruction
Peptic Ulcer (most common) - Inflammation blocking or strictures
Gallstone (Bouveret Syndrome) - Cholecystoduodenal fistula allows passage of a gallstone into the duodenum, which can cause obstruction
Congenital Pyloric Stenosis in children
Pancreatic Pseudocyst – Can compress gastric outlet
Bezoar - Indigestible Mass in the GI system e.g. hair/cellulose
Strictures form inflammation or corrosives
Pancreatic Cancer (most common)
Ampulla of Vater Cancer
Gastric Cancer - Adenocarcinoma, Lymphoma, GI stromal Tumours
What will you find in a history taking of Gastric Outlet Obstruction?
Nausea and Vomiting - Non Bilious Vomit (Has only entered stomach) within 1 hour of meals
What are the signs of gastric outlet obstruction?
End of the bed:
Bruising - Malnutrition
Dilated LUQ/Epigastric Mass that may be the dilated stomach
Ascites - Hypoalbuminea due to malnutrition
Oedema- Hypoalbuminea due to malnutrition
What are the complications of gastric outlet obstruction?
Metabolic Alkalosis with Hyponatreamia and Hypokalaemia - Aldosterone secretion from kidney in resposne to dehydration leads to loss of more H+ and K+
What investigations will you order in gastric outlet obstruction?
Urine Dipstick - May show paradoxical high K+ and K+ a they are excrete by kidneys for Na+. May just show deficiency in those 3
FBC (Anaemia or WCC)
LFT's (Rule out mets)
ABG - Constant vomitting (Metabolic Alkalosis)
UnE - Electrolytes and dehydration
13C Urea Breath test in suspected peptic ulcer