Gastric outlet obstruction
Contents
- 1 Leading cause of Gastroparesis is
- 2 The most common cause of gastric outlet obstruction is
- 3 Following are the features of gastric outlet obstruction except
- 4 Not true regarding diagnosis of gastric outlet obstruction
- 5 Benign gastric outlet obstruction is best treated by
- 6 Which of the following gastric polyp has high malignant potential
- 7 In short
- 8 Benign gastric outlet obstruction
- 9 Severe vomiting
- 10 Metabolic abnormality of hypochloremic alkalosis
- 11 Endoscopy
- 12 Saline load test
Leading cause of Gastroparesis is
A. Norwalk virus infection
B. Bariatric procedures
C. Diabetes mellitus
D. Amyloidosis
The most common cause of gastric outlet obstruction is
A. Peptic ulceration
B. Perforation of duodenal ulcer
C. Pancreatic adenocarcinoma
D. Distal gastric cancer
Following are the features of gastric outlet obstruction except
A. Hypocalcemia
B. Hypochloremic metabolic alkalosis
C. Hypergastrinemia
D. Hyperkalemia
Not true regarding diagnosis of gastric outlet obstruction
A. Absence of contrast in the small intestine in barium meal X ray
B. CT scan not useful
C. Endoscopy should be performed after fasting for over 4 hours
D. Hypochloremic alkalosis is a significant finding
Benign gastric outlet obstruction is best treated by
A. Intraluminal stent insertion
B. Gastrojejunostomy
C. Endoscopic balloon dilation
D. Pyloroplasty
Which of the following gastric polyp has high malignant potential
A. Gastrointestinal stromal tumor
B. Neuroendocrine tumor
C. Hyperplastic polyp
D. Fundic gland polyp
In short
Benign gastric outlet obstruction
In benign GOO caused by PUD, conservative management should be tried first, including acid suppression, NSAID avoidance, testing for and treating H. pylori.
Severe vomiting
Hypokalemia and hypochloremic metabolic alkalosis are often present from severe vomiting. Increased serum gastrin levels can be seen as abdominal distension induces gastrin release.
Metabolic abnormality of hypochloremic alkalosis
The metabolic abnormality of hypochloremic alkalosis is usually only seen with peptic ulcer disease and should be treated with isotonic saline with potassium.
Endoscopy
Endoscopy is generally needed to confirm and establish the specific cause of the obstruction. A nasogastric tube should be inserted and suction should be done before endoscopy to reduce the risk of aspiration.
Saline load test
Following gastric decompression, to further evaluate mechanical outlet obstruction, a saline load test can be helpful. The saline load (750 ml) is emptied into a patient’s stomach through a nasogastric tube. If more than 400 mL gastric contents are aspirated after 30 minutes, it is considered a positive test.
