A rare cause of gastric outlet obstruction

Authors

  • Abhishek Murali Department of General Surgery, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India
  • Rohit Krishnappa Department of General Surgery, Dr. Chandramma Dayananda Sagar Institute of Medical Education and Research, Harohalli, Bangalore, Karnataka, India
  • Rajesh B. Murugesh Department of Surgical Gastroenterology, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India
  • S. Rajagopalan Department of General Surgery, Dr. Chandramma Dayananda Sagar Institute of Medical Education and Research, Harohalli, Bangalore, Karnataka, India

DOI:

https://doi.org/10.18203/2349-2902.isj20202437

Keywords:

Gastric outlet obstruction, Duodenal ulcers, Peripyloric adhesions

Abstract

Gastric outlet obstruction is the clinical and pathophysiological consequence of any disease process that produces mechanical impediment to gastric emptying. It may be acute from inflammatory swelling and peristaltic dysfunction or chronic from cicatrix. Chronic inflammation of the duodenum may lead to recurrent episodes of healing followed by repair and scarring ultimately leading to fibrosis and stenosis of the duodenal lumen. We would like to present a unique case of an elderly lady presenting with intractable vomiting over 3 months, gradually progressive which aggravated on consuming solids initially to consuming liquids later. After thorough investigations a provisional diagnosis of chronic duodenal ulcer with gastric outlet obstruction probably due to cicatrix was made. On laparotomy there was a chronic scarred duodenal ulcer following a previously contained perforation which was causing the gastric outlet obstruction. Cholecystectomy, duodenoplasty and loop gastrojejunostomy was performed with no complications post-operatively. This is a rare case of previous contained duodenal perforation causing gastric outlet obstruction.

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Published

2020-05-26

Issue

Section

Case Reports