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