Makindo Medical Notes"One small step for man, one large step for Makindo" |
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๐ซ๐ฒ Severe gastric outlet obstruction (GOO) in adults is a serious condition. ๐ Always exclude functional/non-mechanical causes (e.g. diabetic gastroparesis). โฑ๏ธ Prompt diagnosis & intervention are essential to prevent complications.
| โ ๏ธ Severe Gastric Outlet Obstruction (Pyloric Stenosis) in Adults |
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A 72-year-old presents with weeks of early satiety, post-prandial vomiting of stale food, and weight loss; exam shows visible peristalsis with a succussion splash, mild epigastric tenderness, and dehydration. Labs reveal hypochloraemic, hypokalaemic metabolic alkalosis (vomiting) and AKI stage 1; CXR is clear. Initial management is NBM, large-bore NG tube decompression, aggressive IV fluids with potassium and chloride repletion, and PPI. CT abdomen (contrast) suggests distal gastric narrowing; OGD confirms antral/pyloric stricture with biopsies to exclude malignancy (common adult causes: gastric cancer, pancreatic cancer, less often peptic-ulcer scarring). After resuscitation, options include endoscopic balloon dilation/stenting for benign disease or palliation, versus surgical bypass or resection guided by MDT and staging.