An observational study on benign/malignant gastric outlet obstruction in tertiary care centre of RIMS, Ranchi, India
DOI:
https://doi.org/10.18203/2349-2902.isj20175504Keywords:
Carcinoma of stomach, Malignant and benign gastric outlet obstruction, Peptic ulcer diseaseAbstract
Background: Gastric outlet obstruction is a group of clinico-patho physiological consequence of mechanical impediment of gastric emptying. Clinical entities that can result in gastric outlet obstruction are categorized into two well-defined groups of causes - benign and malignant. The proximal stomach is now the most common site for gastric carcinoma in the west but in Japan and developing countries like India the distal gastric cancer (antrum 13% and pylorus 7%) still predominates. Diagnosis of gastric outlet obstruction depends on different clinical features and certain investigations. The definitive treatment involves surgical relief of the gastric outlet obstruction. The correct surgical procedure to be adopted is planned according to the cause of obstruction and condition of the patients. This is an observational study aimed for characterization of gastric outlet obstruction in terms of benign and malignant and their relation to its causes, sites and other related factors in tertiary care centre (RIMS).
Methods: This is an observational study comprises on 50 patients of gastric outlet obstruction admitted in the Department of Surgery R.I.M.S., Ranchi. The provisional diagnosis was based on detailed clinical history, thorough physical examinations, and some radiological investigations.
Results: Majority of the patients of gastric outlet obstruction were malignant lesions of stomach and very few are benign. Antral carcinoma of stomach was found to be the commonest etiology of gastric outlet obstruction followed by pyloric stenosis secondary to acid peptic disorders. Most of the patient was in the age group of 40 to 60 years of age, males were affected more than Females.
Conclusions: Gastric outlet obstruction in adults, a surgical problem of either sex, results commonly due to antral carcinoma or pyloric stenosis secondary to acid peptic disorder.
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References
Ellis H. The surgery of stomach and duodenum. In: Nyhus ed. Anderson, 1977:459.
Ezberci F, Kargi H, Ergin A. Gastric outlet obstruction by gall stone obstruction sec. to pancreatic ca.; Surgical Vs endoscopic palliation; 2000.
Boylan JJ, Gradzka MI. Long-term results of endoscopic balloon dilatation for gastric outlet obstruction. Dig Dis Sci. 1999;44(9):1883-6.
Park KB, Do YS, Kang WK, Choo SW, Han YH, Suh SW, et al. Malignant obstruction of gastric outlet and duodenum: palliation with flexible covered metallic stents. Radiol. 2001;219(3):679-83.
Gibson JB. Behrman SW. Fabian TC. Britt LG. J. of American coil. of Surgeon. 2000;191(1):32-7.
DeBakey M, Ochsner A. Bezoars and concretions. Surg. 1938;4(6):934-63.
Kreel L, Ellis H. Gut. Pyloric stenosis in adults- a clinical and radiological study. 1965 Jun;6(3):253-61.
Bockus HL. Gastroentero. Bockus 1943 and Hurst 1946. 1943;1:502-613.
Nayak SK. In Thesis for the degree of Master of Surgery, R.U., Ranchi. 67,1984. Miculicz. The Surgery of Stomach & Duod. Nyhus 1977:23.
Abouna GM, Veazey PR, Terry DB. Intravenous infusion of hydrochloric acid for treatment of severe metabolic alkalosis. Surg. 1974;75(2):194-202.
Haubrich WS. In Henry L. Bockus (ed.) Gastroenterolo; 2nd Ed, Philadelphia: Saunders, 1963:2.
Awan A, Johnston DE, Jamal MM. Gastric outlet obstruction with benign endoscopic biopsy should be further explored for malignancy. Gastrointestinal endoscopy. 1998 Nov 30;48(5):497-500.
Stupart DA, Panieri E, Dent DM. Gastrojejunostomy for gastric outlet obstruction in patients with gastric carcinoma. Sout Af J Surg. 2006;44(2):52-4.
Fiocca F, Ceci V, Donatelli G, Moretta MG, Santagati A, Sportelli G. Palliative treatment of upper gastrointestinal obstruction using self-expansible metal stents. European review for medical and pharmacological sciences. 2006;10(4):179.
Von Eiselsbirg. The surgery of the Stomach and Duodenum, 2nd Ed. J & A Churchill Ltd. London, 1888. Hippocrates and Gale.
Biilroth CWT, Nyhus and Wastell. Quoted by the surgery of stomach and duodenum, 3rd Ed. 1881:5.
Barkman DM. Coil Papers Mayo Clin. 1923;15:92. William Mayo in 1911.
Moynihan B.G.A. In duodenal ulcer. 2nd Ed. Philadelphia Saunders; 1912.
Davis NPW, Williams JA. Am. J. Surg.,121:260,1971- late results of bilateral selective vagotomy and pyloroplasty for duodenal ulcer. 1971;121:260.
Kozoll DD, Meyer KA. Obstructing duodenal ulcer, general factors influencing incidence and mortality, Arch.Surg.1964;88:793-799.
Kaushik SP, Moses T. Ind. J. Surg. End. Jour. Med. Res. 1973;61(10):1513.
Goldstein H, Janin M, Schapiro M, Boyle JD. Gastric retention associated with gastroduodenal disease- Am. J. Dig. Dis. 1966;11(11):887-97.