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gastric outlet obstruction

Description

Signs and Symptoms

Diagnostic Tests

Gastric outlet obstruction (GOO) can be diagnosed using various tests, which help identify the underlying cause and confirm the presence of mechanical obstruction in the distal stomach, pylorus, or duodenum.

Imaging Studies

  • CT scan: Provides detailed images of the stomach, duodenum, and surrounding organs to identify potential causes of obstruction [1].
  • Barium swallow studies: Helps diagnose GOO by visualizing the shape and movement of food through the digestive tract [5][8].

Endoscopy

  • Upper gastrointestinal endoscopy: Offers a direct visual examination of the upper digestive tract, allowing for the identification of potential causes such as tumors or ulcers [5].

Other Tests

  • Ultrasonography: Can be used to diagnose GOO by assessing gastric emptying and detecting any mechanical obstructions [7].
  • Plain radiography: May show a large gastric shadow, indicating possible obstruction [8].
  • Contrast studies: Such as barium X-rays, can help visualize the shape of the stomach and pylorus, aiding in diagnosis [9].

Diagnostic Criteria

  • A test for H. pylori is helpful when diagnosing peptic ulcer disease, which is a common cause of GOO [2].
  • The presence of symptoms such as nausea, vomiting, abdominal pain, and early satiety can also indicate GOO [10][13].

It's essential to note that the choice of diagnostic test may depend on the suspected underlying cause of GOO and individual patient factors. A comprehensive evaluation by a healthcare professional is necessary to determine the best course of action.

References:

[1] Context 1 [5] Context 5 [7] Context 7 [8] Context 8 [9] Context 9 [10] Context 10 [13] Context 13

Treatment

Differential Diagnosis

Differential Diagnosis of Gastric Outlet Obstruction

Gastric outlet obstruction (GOO) is a clinical condition characterized by mechanical blockage in the pylorus, distal stomach, or duodenum, resulting in symptoms such as nausea, vomiting, abdominal pain, and early satiety. The differential diagnosis for GOO depends on various factors, including patient age, presentation, and underlying conditions.

Common Differential Diagnoses:

  • Gastroparesis [8][10]
  • Small bowel obstruction
  • Ileus
  • Hiatal hernia
  • Gastroesophageal reflux disease (GERD)
  • Adrenal insufficiency
  • Early gastric carcinoma
  • Gastric cancer [4]

Age-Specific Differential Diagnoses:

  • In adolescent patients, congenital sources of obstruction such as diaphragmatic hernias, webs, or luminal obstruction with mucosal valves or heterotrophic pancreas should be considered [8].
  • In adults, the differential diagnosis for GOO may include various conditions such as ampullary cancer, duodenal cancer, cholangiocarcinomas, and gastric cancer [4].

Other Differential Diagnoses:

  • Metastases to the stomach or duodenum
  • Gastric polyps (such as those seen in upper endoscopy images) [6]
  • Mucosal valves or heterotrophic pancreas

It is essential to maintain a broad list of possible differential diagnoses for gastric outlet obstruction, as demonstrated by case studies. A comprehensive evaluation and diagnostic workup are necessary to determine the underlying cause of GOO.

References:

[4] Other tumors that may obstruct the gastric outlet include ampullary cancer, duodenal cancer, cholangiocarcinomas, and gastric cancer. [6] Upper endoscopy showing multiple gastric polyps. Such polyps are a major cause of gastric outlet obstruction. [8] The differential diagnosis for gastric outlet obstruction depends on the patient's age. For adolescent patients presenting with suspected GOO, the differential should include congenital sources of obstruction like diaphragms, webs, or luminal obstruction with mucosal valves or heterotrophic pancreas. [10] A key differential for GOO is gastroparesis, ... Gastric Outlet Obstruction (GOO) describes a mechanical obstruction of the proximal gastrointestinal tract resulting in an inability in the stomach to empty.

Additional Differential Diagnoses

Additional Information

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