Gastric Outlet Obstruction

Khullar, Sanjiv; DiSario, James A.

doi:10.1016/s1052-5157(18)30356-8

Cited by 72 publications

(54 citation statements)

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“…It was reported that obstruction was the least (12.9%) specific cause of PU disease in patients requiring surgery (12). Recently, acquired gastric outlet obstruction is more commonly related to malignancy than to ulcer disease (24). In their cohort study, comparing the results of 1977 with 1989 Makela et al (25) reported that before and after the introduction of H 2 -receptor antagonists, operations performed for obstruction did not increase, varying from 0.8 to 2.2 per 10 5 individuals over the study.…”

Section: Original Articlementioning

confidence: 95%

Peptic ulcer complications requiring surgery: What has changed in the last 50 years in Turkey

Güzel

Kahramanca²,

Seker³

et al. 2014

Turk J Gastroenterol

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Background/Aims: The incidence and prevalence of peptic ulcer disease has decreased in recent years, but it is not so easy to make the same conclusion when complications of peptic ulcer are taken into consideration. The aim of this study is to determine the time trends in complicated peptic ulcer disease and to state the effects of H2 receptor blockers, proton pump inhibitors (PPI), and H. pylori eradication therapies on these complications. Materials and Methods: This study retrospectively evaluated the patients who were operated on for complications (perforation, bleeding, and obstruction) of peptic ulcer for the last 50 years. Patients were grouped into four groups (G1-G4) according to the dates in which H2 receptor blockers, PPIs, and eradication regimens for H. pylori were introduced The time periods that were studied were: (G1) 1962-1980, (G2) 1981-1990, (G3) 1991-1997, and (G4) 1998-2012. Results: In total, 2953 patients were operated on for complications of peptic ulcer disease, of which 86% of the patients were male. In G1, perforation and obstruction were significantly the most frequent complications (p<0.001), followed by bleeding. In groups G2 and G3, obstruction was still the most frequent complication requiring surgery (p<0.001). In G2 and G3, obstruction was followed by perforation and bleeding, respectively. In G4, perforation was significantly the most frequent complication (p<0.001). Conclusion: From 1962 to 1990 obstruction was the most common complication requiring surgery. In the last decade, perforation became the most common complication. In contrast to reports in the literature, bleeding was the least common complication requiring surgery in Turkey.

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Section: Original Articlementioning

confidence: 95%

Peptic ulcer complications requiring surgery: What has changed in the last 50 years in Turkey

Güzel

Kahramanca²,

Seker³

et al. 2014

Turk J Gastroenterol

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“…Malignancy 1,2 is common cause of GOO in adults, but many pa ents with GOO have benign causes. This study focused on various e ologies of GOO, their prevalence, the management op ons and outcome of the management.…”

Section: Discussionmentioning

confidence: 99%

“…Gastric outlet obstruc on (GOO) involves obstruc on in the antro-pyloric region or bulbar or post bulbar segment of 1,2 duodenum. Malignancy is common cause of GOO in adults, but many pa ents with GOO have benign causes which includes pep c ulcer disease (PUD), caus c inges on, postopera ve anastomo c stricture and inflammatory condi ons such as Crohn's disease and tuberculosis.…”

Section: Introductionmentioning

confidence: 99%

Trend in Gastric Outlet Obstruction at Patients Attending Tribhuvan University Teaching Hospital, Kathmandu, Nepal

Thakur

Ghimire

Singh³

2017

Birat J. Health Sci.

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IntroductionGastric outlet obstruction (GOO) involves obstruc_on in the antro-pyloric region or bulb of duodenum. Malignancy is common cause of GOO in adults but many patients with GOO have benign causes. Despite the improvement in medical management, about 5% patients with complicated duodenal ulcer disease and 1%-2% with complicated gastric ulcer disease respectively develop this problem.ObjectiveThe purpose of this study was to find the etiologies of GOO, their management options and outcome in Tribhuvan University Teaching Hospital.MethodologyIn this retrospective study, the records of 44 patients admited with diagnosis of GOO from September 2007 to August 2010 in the Department of Surgery, Tribhuvan University Teaching Hospital, Kathmandu, Nepal were retrieved. Patients' demography, etiologies of GOO, treatment given and their outcome were analysed.ResultsThirty two patients (73%) were male and 12 (27%) were female with M:F ratio of 2.7:1. The mean age of patients was 57.40 years and duration of symptoms 2.68 months. Carcinoma of stomach, 28 cases (64%) was most common ecology of GOO followed by PUD, 9 (21%), duodenal malignancy,3 (7%), corrosive stricture, 2 (5%), advanced gallbladder carcinoma, 1 (2%) and chronic pancreatis, 1 (2%). Seventeen (39%) patients were treated by gastrojejunostomy, 14 (32%) by subtotal gastrectomy and gastrojejunostomy, 5 (11%) by truncal vagotomy and gastrojejunostomy, 4 (9%) by medical management, 2 (4.5%) by feeding jejunostomy, and 2 (4.5%) were discharged on request. Complications occurred in 7 (16%) patients and mortality in 1 (2%). Twenty three (52%) patients were candidates for chemotherapy either in an adjuvant or palliative seting.ConclusionGastric malignancy was the most common cause of gastric outlet obstruction. Most of the patients in our setup presented with advanced disease and were candidates of palliative treatment only. Birat Journal of Health Sciences Vol.2/No.1/Issue 2/ Jan - April 2017, Page: 219-221

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“…Although malignancies are common causes of GOO (23,24), a significant number of patients have benign causes. GWAs, also causes of GOO, are rare and potentially fatal conditions that require early diagnosis and appropriate management.…”

Section: Case Reportmentioning

confidence: 99%