Gastric outlet obstruction: Difference between revisions

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==== Benign causes ====
==== Benign causes ====
[[Acquired disorder|Acquired]]:  
[[Acquired disorder|Acquired]]:<ref name="pmid7235767">{{cite journal |vauthors=Bradley EL, Clements JL |title=Idiopathic duodenal obstruction: an unappreciated complication of pancreatitis |journal=Ann. Surg. |volume=193 |issue=5 |pages=638–48 |year=1981 |pmid=7235767 |pmc=1345138 |doi= |url=}}</ref><ref name="pmid1539568">{{cite journal |vauthors=Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK |title=Ingestion of strong corrosive alkalis: spectrum of injury to upper gastrointestinal tract and natural history |journal=Am. J. Gastroenterol. |volume=87 |issue=3 |pages=337–41 |year=1992 |pmid=1539568 |doi= |url=}}</ref><ref name="pmid15332026">{{cite journal |vauthors=Poley JW, Steyerberg EW, Kuipers EJ, Dees J, Hartmans R, Tilanus HW, Siersema PD |title=Ingestion of acid and alkaline agents: outcome and prognostic value of early upper endoscopy |journal=Gastrointest. Endosc. |volume=60 |issue=3 |pages=372–7 |year=2004 |pmid=15332026 |doi= |url=}}</ref><ref name="pmid10079337">{{cite journal |vauthors=Ciftci AO, Senocak ME, Büyükpamukçu N, Hiçsönmez A |title=Gastric outlet obstruction due to corrosive ingestion: incidence and outcome |journal=Pediatr. Surg. Int. |volume=15 |issue=2 |pages=88–91 |year=1999 |pmid=10079337 |doi=10.1007/s003830050523 |url=}}</ref>
* [[Acute (medicine)|Acute]]- [[edema]] and [[inflammation]]  
* [[Acute (medicine)|Acute]]- [[edema]] and [[inflammation]]  
* [[Chronic (medical)|Chronic]]- due to intrinsic [[obstruction]] as a result of [[fibrosis]] and [[scar]] formation  
* [[Chronic (medical)|Chronic]]- due to intrinsic [[obstruction]] as a result of [[fibrosis]] and [[scar]] formation  
** [[Peptic ulcer|PUD]]: 5% cases (most commonly affecting [[pylorus]] and initial part of the [[duodenum]])  
** [[Peptic ulcer|PUD]]: 5% cases (most commonly affecting [[pylorus]] and initial part of the [[duodenum]])  
** [[Polyps|Gastric polyps]]  
** [[Polyps|Gastric polyps]]<ref name="pmid7129059">{{cite journal |vauthors=Miner PB, Harri JE, McPhee MS |title=Intermittent gastric outlet obstruction from a pedunculated gastric polyp |journal=Gastrointest. Endosc. |volume=28 |issue=3 |pages=219–20 |year=1982 |pmid=7129059 |doi= |url=}}</ref><ref name="pmid12831404">{{cite journal |vauthors=Gencosmanoglu R, Sen-Oran E, Kurtkaya-Yapicier O, Tozun N |title=Antral hyperplastic polyp causing intermittent gastric outlet obstruction: case report |journal=BMC Gastroenterol |volume=3 |issue= |pages=16 |year=2003 |pmid=12831404 |pmc=166166 |doi=10.1186/1471-230X-3-16 |url=}}</ref>
** [[Caustic|Caustic ingestion]]  
** [[Caustic|Caustic ingestion]]<ref name="pmid2753330">{{cite journal |vauthors=Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK |title=Ingestion of corrosive acids. Spectrum of injury to upper gastrointestinal tract and natural history |journal=Gastroenterology |volume=97 |issue=3 |pages=702–7 |year=1989 |pmid=2753330 |doi= |url=}}</ref>
** Duodenal stricture <ref name="pmid2000520">{{cite journal |vauthors=Taylor SM, Adams DB, Anderson MC |title=Duodenal stricture: a complication of chronic fibrocalcific pancreatitis |journal=South. Med. J. |volume=84 |issue=3 |pages=338–41 |year=1991 |pmid=2000520 |doi= |url=}}</ref><ref name="pmid2000520">{{cite journal |vauthors=Taylor SM, Adams DB, Anderson MC |title=Duodenal stricture: a complication of chronic fibrocalcific pancreatitis |journal=South. Med. J. |volume=84 |issue=3 |pages=338–41 |year=1991 |pmid=2000520 |doi= |url=}}</ref>
** Systemic amyloidosis of the gastrointestinal tract <ref name="pmid8331978">{{cite journal |vauthors=Menke DM, Kyle RA, Fleming CR, Wolfe JT, Kurtin PJ, Oldenburg WA |title=Symptomatic gastric amyloidosis in patients with primary systemic amyloidosis |journal=Mayo Clin. Proc. |volume=68 |issue=8 |pages=763–7 |year=1993 |pmid=8331978 |doi= |url=}}</ref><ref name="pmid9891699">{{cite journal |vauthors=Friedman S, Janowitz HD |title=Systemic amyloidosis and the gastrointestinal tract |journal=Gastroenterol. Clin. North Am. |volume=27 |issue=3 |pages=595–614, vi |year=1998 |pmid=9891699 |doi= |url=}}</ref>
** Eosinophillic gastroenteritis <ref name="pmid10660821">{{cite journal |vauthors=Khan S, Orenstein SR |title=Eosinophilic gastroenteritis masquerading as pyloric stenosis |journal=Clin Pediatr (Phila) |volume=39 |issue=1 |pages=55–7 |year=2000 |pmid=10660821 |doi=10.1177/000992280003900109 |url=}}</ref><ref name="pmid11400803">{{cite journal |vauthors=Chaudhary R, Shrivastava RK, Mukhopadhyay HG, Diwan RN, Das AK |title=Eosinophilic gastritis--an unusual cause of gastric outlet obstruction |journal=Indian J Gastroenterol |volume=20 |issue=3 |pages=110 |year=2001 |pmid=11400803 |doi= |url=}}</ref><ref name="pmid17614041">{{cite journal |vauthors=Tursi A, Rella G, Inchingolo CD, Maiorano M |title=Gastric outlet obstruction due to gastroduodenal eosinophilic gastroenteritis |journal=Endoscopy |volume=39 Suppl 1 |issue= |pages=E184 |year=2007 |pmid=17614041 |doi=10.1055/s-2006-945125 |url=}}</ref><ref name="pmid14669340">{{cite journal |vauthors=Chen MJ, Chu CH, Lin SC, Shih SC, Wang TE |title=Eosinophilic gastroenteritis: clinical experience with 15 patients |journal=World J. Gastroenterol. |volume=9 |issue=12 |pages=2813–6 |year=2003 |pmid=14669340 |pmc=4612059 |doi= |url=}}</ref><ref name="pmid8420276">{{cite journal |vauthors=Lee CM, Changchien CS, Chen PC, Lin DY, Sheen IS, Wang CS, Tai DI, Sheen-Chen SM, Chen WJ, Wu CS |title=Eosinophilic gastroenteritis: 10 years experience |journal=Am. J. Gastroenterol. |volume=88 |issue=1 |pages=70–4 |year=1993 |pmid=8420276 |doi= |url=}}</ref>
** [[Obstruction]] by [[Gallstone disease|gallstones]] (Bouveret syndrome)  
** [[Obstruction]] by [[Gallstone disease|gallstones]] (Bouveret syndrome)  
** Complication of [[acute pancreatitis]]: [[pancreatic pseudocyst]] formation  
** Complication of [[acute pancreatitis]]: [[pancreatic pseudocyst]] formation<ref name="pmid6732492">{{cite journal |vauthors=Aranha GV, Prinz RA, Greenlee HB, Freeark RJ |title=Gastric outlet and duodenal obstruction from inflammatory pancreatic disease |journal=Arch Surg |volume=119 |issue=7 |pages=833–5 |year=1984 |pmid=6732492 |doi= |url=}}</ref><ref name="pmid4811173">{{cite journal |vauthors=Agrawal NM, Gyr N, McDowell W, Font RG |title=Intestinal obstruction due to acute pancreatitis. Case report and review of literature |journal=Am J Dig Dis |volume=19 |issue=2 |pages=179–85 |year=1974 |pmid=4811173 |doi= |url=}}</ref>
** [[Bezoar|Bezoars]]
** Chronic pancreatitis <ref name="pmid2658160">{{cite journal |vauthors=Bradley EL |title=Complications of chronic pancreatitis |journal=Surg. Clin. North Am. |volume=69 |issue=3 |pages=481–97 |year=1989 |pmid=2658160 |doi= |url=}}</ref><ref name="pmid19629001">{{cite journal |vauthors=Levenick JM, Gordon SR, Sutton JE, Suriawinata A, Gardner TB |title=A comprehensive, case-based review of groove pancreatitis |journal=Pancreas |volume=38 |issue=6 |pages=e169–75 |year=2009 |pmid=19629001 |doi=10.1097/MPA.0b013e3181ac73f1 |url=}}</ref>
Congenital:<ref name="pmid18668780">{{cite journal |vauthors=Kreel L, Ellis H |title=Pyloric stenosis in adults: A clinical and radiological study of 100 consecutive patients |journal=Gut |volume=6 |issue=3 |pages=253–61 |year=1965 |pmid=18668780 |pmc=1552275 |doi= |url=}}</ref>  
** Sarcoidosis of the GIT <ref name="pmid2180656">{{cite journal |vauthors=Stampfl DA, Grimm IS, Barbot DJ, Rosato FE, Gordon SJ |title=Sarcoidosis causing duodenal obstruction. Case report and review of gastrointestinal manifestations |journal=Dig. Dis. Sci. |volume=35 |issue=4 |pages=526–32 |year=1990 |pmid=2180656 |doi= |url=}}</ref><ref name="pmid807981">{{cite journal |vauthors=Johnson FE, Humbert JR, Kuzela DC, Todd JK, Lilly JR |title=Gastric outlet obstruction due to X-linked chronic granulomatous disease |journal=Surgery |volume=78 |issue=2 |pages=217–23 |year=1975 |pmid=807981 |doi= |url=}}</ref><ref name="pmid6623357">{{cite journal |vauthors=Mulholland MW, Delaney JP, Simmons RL |title=Gastrointestinal complications of chronic granulomatous disease: surgical implications |journal=Surgery |volume=94 |issue=4 |pages=569–75 |year=1983 |pmid=6623357 |doi= |url=}}</ref><ref name="pmid16970572">{{cite journal |vauthors=Huang A, Abbasakoor F, Vaizey CJ |title=Gastrointestinal manifestations of chronic granulomatous disease |journal=Colorectal Dis |volume=8 |issue=8 |pages=637–44 |year=2006 |pmid=16970572 |doi=10.1111/j.1463-1318.2006.01030.x |url=}}</ref>
** [[Bezoar|Bezoars]]<ref name="pmid9291515">{{cite journal |vauthors=Bakken DA, Abramo TJ |title=Gastric lactobezoar: a rare cause of gastric outlet obstruction |journal=Pediatr Emerg Care |volume=13 |issue=4 |pages=264–7 |year=1997 |pmid=9291515 |doi= |url=}}</ref><ref name="pmid10328129">{{cite journal |vauthors=De Backer A, Van Nooten V, Vandenplas Y |title=Huge gastric trichobezoar in a 10-year-old girl: case report with emphasis on endoscopy in diagnosis and therapy |journal=J. Pediatr. Gastroenterol. Nutr. |volume=28 |issue=5 |pages=513–5 |year=1999 |pmid=10328129 |doi= |url=}}</ref><ref name="pmid9663194">{{cite journal |vauthors=Phillips MR, Zaheer S, Drugas GT |title=Gastric trichobezoar: case report and literature review |journal=Mayo Clin. Proc. |volume=73 |issue=7 |pages=653–6 |year=1998 |pmid=9663194 |doi=10.1016/S0025-6196(11)64889-1 |url=}}</ref><ref name="pmid14738689">{{cite journal |vauthors=White NB, Gibbs KE, Goodwin A, Teixeira J |title=Gastric bezoar complicating laparoscopic adjustable gastric banding, and review of literature |journal=Obes Surg |volume=13 |issue=6 |pages=948–50 |year=2003 |pmid=14738689 |doi=10.1381/096089203322618849 |url=}}</ref><ref name="pmid16448609">{{cite journal |vauthors=Zapata R, Castillo F, Córdova A |title=[Gastric food bezoar as a complication of bariatric surgery. Case report and review of the literature] |language=Spanish; Castilian |journal=Gastroenterol Hepatol |volume=29 |issue=2 |pages=77–80 |year=2006 |pmid=16448609 |doi= |url=}}</ref><ref name="pmid14738689">{{cite journal |vauthors=White NB, Gibbs KE, Goodwin A, Teixeira J |title=Gastric bezoar complicating laparoscopic adjustable gastric banding, and review of literature |journal=Obes Surg |volume=13 |issue=6 |pages=948–50 |year=2003 |pmid=14738689 |doi=10.1381/096089203322618849 |url=}}</ref>
**Gastro-duodenal tuberculosis<ref name="pmid12703983">{{cite journal |vauthors=Amarapurkar DN, Patel ND, Amarapurkar AD |title=Primary gastric tuberculosis--report of 5 cases |journal=BMC Gastroenterol |volume=3 |issue= |pages=6 |year=2003 |pmid=12703983 |pmc=155648 |doi= |url=}}</ref><ref name="pmid15540690">{{cite journal |vauthors=Rao YG, Pande GK, Sahni P, Chattopadhyay TK |title=Gastroduodenal tuberculosis management guidelines, based on a large experience and a review of the literature |journal=Can J Surg |volume=47 |issue=5 |pages=364–8 |year=2004 |pmid=15540690 |pmc=3211943 |doi= |url=}}</ref><ref name="pmid16217956">{{cite journal |vauthors=Padussis J, Loffredo B, McAneny D |title=Minimally invasive management of obstructive gastroduodenal tuberculosis |journal=Am Surg |volume=71 |issue=8 |pages=698–700 |year=2005 |pmid=16217956 |doi= |url=}}</ref><ref name="pmid8677960">{{cite journal |vauthors=Di Placido R, Pietroletti R, Leardi S, Simi M |title=Primary gastroduodenal tuberculous infection presenting as pyloric outlet obstruction |journal=Am. J. Gastroenterol. |volume=91 |issue=4 |pages=807–8 |year=1996 |pmid=8677960 |doi= |url=}}</ref><ref name="pmid3605037">{{cite journal |vauthors=Subei I, Attar B, Schmitt G, Levendoglu H |title=Primary gastric tuberculosis: a case report and literature review |journal=Am. J. Gastroenterol. |volume=82 |issue=8 |pages=769–72 |year=1987 |pmid=3605037 |doi= |url=}}</ref>
Congenital:<ref name="pmid18668780">{{cite journal |vauthors=Kreel L, Ellis H |title=Pyloric stenosis in adults: A clinical and radiological study of 100 consecutive patients |journal=Gut |volume=6 |issue=3 |pages=253–61 |year=1965 |pmid=18668780 |pmc=1552275 |doi= |url=}}</ref><ref name="pmid12145672">{{cite journal |vauthors=Gheorghe L, Băncilă I, Gheorghe C, Herlea V, Vasilescu C, Aposteanu G |title=Antro-duodenal tuberculosis causing gastric outlet obstruction--a rare presentation of a protean disease |journal=Rom J Gastroenterol |volume=11 |issue=2 |pages=149–52 |year=2002 |pmid=12145672 |doi= |url=}}</ref>  
* [[Pyloric stenosis]]:   
* [[Pyloric stenosis]]:   
** most common cause in children   
** most common cause in children   
** more common in boys>girls  
** more common in boys>girls  
** due to [[Hypertrophy (medical)|hypertrophy]] of [[Pyloric antrum|pyloric]] circular [[Smooth muscle|smooth muscles]]   
** due to [[Hypertrophy (medical)|hypertrophy]] of [[Pyloric antrum|pyloric]] circular [[Smooth muscle|smooth muscles]]   
* [[Congenital disorder|Congenital]] [[Duodenum|duodenal]] webs  
* [[Congenital disorder|Congenital]] [[Duodenum|duodenal]] webs<ref name="pmid10876738">{{cite journal |vauthors=Adebamowo CA, Oduntan O |title=Duodenal web causing gastric outlet obstruction in an adult |journal=West Afr J Med |volume=18 |issue=1 |pages=73–4 |year=1999 |pmid=10876738 |doi= |url=}}</ref>
* [[Annular pancreas]]  
* [[Annular pancreas]]<ref name="pmid7771437">{{cite journal |vauthors=Urayama S, Kozarek R, Ball T, Brandabur J, Traverso L, Ryan J, Wechter D |title=Presentation and treatment of annular pancreas in an adult population |journal=Am. J. Gastroenterol. |volume=90 |issue=6 |pages=995–9 |year=1995 |pmid=7771437 |doi= |url=}}</ref>


==== Malignant causes ====
==== Malignant causes ====
Line 60: Line 66:
*** Most common [[Cancer|malignancy]] leading to extrinsic [[obstruction]] of the [[pylorus]]
*** Most common [[Cancer|malignancy]] leading to extrinsic [[obstruction]] of the [[pylorus]]
*** Occurence in one fifth of [[Patient|patients]]
*** Occurence in one fifth of [[Patient|patients]]
** [[Stomach]]: [[Stomach cancer|Gastric cancer]]
** [[Stomach]]: [[Stomach cancer|Gastric cancer]], Zollinger Ellison Syndrome <ref name="pmid11144036">{{cite journal |vauthors=Roy PK, Venzon DJ, Shojamanesh H, Abou-Saif A, Peghini P, Doppman JL, Gibril F, Jensen RT |title=Zollinger-Ellison syndrome. Clinical presentation in 261 patients |journal=Medicine (Baltimore) |volume=79 |issue=6 |pages=379–411 |year=2000 |pmid=11144036 |doi= |url=}}</ref>
** [[Duodenum]]: [[Small intestine cancer|Duodenal cancer]], [[Small intestine cancer|ampullary cancer]]  
** [[Duodenum]]: [[Small intestine cancer|Duodenal cancer]], [[Small intestine cancer|ampullary cancer]], Crohn's disease involving the duodenum <ref name="pmid2919581">{{cite journal |vauthors=Nugent FW, Roy MA |title=Duodenal Crohn's disease: an analysis of 89 cases |journal=Am. J. Gastroenterol. |volume=84 |issue=3 |pages=249–54 |year=1989 |pmid=2919581 |doi= |url=}}</ref><ref name="pmid16278730">{{cite journal |vauthors=Kefalas CH |title=Gastroduodenal Crohn's disease |journal=Proc (Bayl Univ Med Cent) |volume=16 |issue=2 |pages=147–51 |year=2003 |pmid=16278730 |pmc=1201000 |doi= |url=}}</ref><ref name="pmid9360875">{{cite journal |vauthors=Matsui T, Hatakeyama S, Ikeda K, Yao T, Takenaka K, Sakurai T |title=Long-term outcome of endoscopic balloon dilation in obstructive gastroduodenal Crohn's disease |journal=Endoscopy |volume=29 |issue=7 |pages=640–5 |year=1997 |pmid=9360875 |doi=10.1055/s-2007-1004271 |url=}}</ref><ref name="pmid6106466">{{cite journal |vauthors=Fitzgibbons TJ, Green G, Silberman H, Eliasoph J, Halls JM, Yellin AE |title=Management of Crohn's disease involving the duodenum, including duodenal cutaneous fistula |journal=Arch Surg |volume=115 |issue=9 |pages=1022–8 |year=1980 |pmid=6106466 |doi= |url=}}</ref>
** [[Bile duct]]: [[Cholangiocarcinoma]]
** [[Bile duct]]: [[Cholangiocarcinoma]]
** Secondary [[metastasis]] to the [[Stomach|gastric]] outlet by other primaries
** Secondary [[metastasis]] to the [[Stomach|gastric]] outlet by other primaries
Line 174: Line 180:


==== Sodium chloride load test ====
==== Sodium chloride load test ====
* Procedure: [[Patient]] is infused with 750 mL of [[sodium chloride]] solution into the [[stomach]] via a [[Nasogastric tube|nasogastric tube (NGT)]].
* Procedure: [[Patient]] is infused with 750 mL of [[sodium chloride]] solution into the [[stomach]] via a [[Nasogastric tube|nasogastric tube (NGT)]].<ref name="pmid5831782">{{cite journal |vauthors=Goldstein H, Boyle JD |title=The saline load test--a bedside evaluation of gastric retention |journal=Gastroenterology |volume=49 |issue=4 |pages=375–80 |year=1965 |pmid=5831782 |doi= |url=}}</ref><ref name="pmid5831782">{{cite journal |vauthors=Goldstein H, Boyle JD |title=The saline load test--a bedside evaluation of gastric retention |journal=Gastroenterology |volume=49 |issue=4 |pages=375–80 |year=1965 |pmid=5831782 |doi= |url=}}</ref>
* In case > 400 mL is left in the [[stomach]] after half an hour, the diagnosis of GOO may be made.
* In case > 400 mL is left in the [[stomach]] after half an hour, the diagnosis of GOO may be made.


Revision as of 21:30, 23 January 2018

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief:

Overview

GASTRIC OUTLET OBSTRUCTION: Pyloric obstruction

Gastric outlet obstruction (GOO,) is the result of any pathology that provides mechanical obstruction to emptying of gastric contents. Two important causes of GOO include: Benign: 37 percent of cases, includes peptic disease Malignant: 53 percent of cases

Location of the stomach: Left upper quadrant of the abdomen Parts of the stomach: Cardia Body Antrum Pylorus


Historical Perspective

Classification

Pathophysiology

Gastric Outlet Obstruction (GOO) may be caused by intrinsic or extrinsic pathologies that involve the antrum and the pylorus.

Causes

Benign causes

Acquired:[1][2][3][4]

Congenital:[34][35]

Malignant causes

Differentiating Gastric outlet obstruction from Other Diseases

Epidemiology and Demographics

  • Incidence: less than 5% in patients with PUD.
  • PUD is the most common benign cause of GOO.
  • In the US, five percent PUD cases require an average of 2000 surgeries annually.
  • Pancreatic cancer is the most common malignant cause of GOO.
  • The incidence of GOO in cases with pancreatic cancer is approximately 20%.

Risk Factors

Screening

Natural History, Complications, and Prognosis

Natural History

Complications

Prognosis

Diagnosis

History and Symptoms

The following history is relevant in patients with GOO:[49][50]

Clinical presentation:

Early stages:[37][5]

Late stages:[51][39][40][52]

Physical Examination

In the late stages of GOO, patients may develop signs of malnutrition and incomplete obstruction.

Laboratory Findings

Imaging Findings

Imaging studies such as plain radiographs, contrast upper gastrointestinal (GI) studies and Computed Tomography (CT) with oral contrast may be used for evaluating patients with symptoms of GOO.

Plain radiographs

Contrast upper gastrointestinal (GI) studies (Gastrografin or barium)

Computed tomography (CT) with oral contrast

Other Diagnostic Studies

Endoscopy

Sodium chloride load test

Needle-guided biopsy

Treatment

Medical Therapy

Surgery

Prevention

References

  1. ↑ Bradley EL, Clements JL (1981). "Idiopathic duodenal obstruction: an unappreciated complication of pancreatitis". Ann. Surg. 193 (5): 638–48. PMC 1345138. PMID 7235767.
  2. ↑ Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK (1992). "Ingestion of strong corrosive alkalis: spectrum of injury to upper gastrointestinal tract and natural history". Am. J. Gastroenterol. 87 (3): 337–41. PMID 1539568.
  3. ↑ Poley JW, Steyerberg EW, Kuipers EJ, Dees J, Hartmans R, Tilanus HW, Siersema PD (2004). "Ingestion of acid and alkaline agents: outcome and prognostic value of early upper endoscopy". Gastrointest. Endosc. 60 (3): 372–7. PMID 15332026.
  4. ↑ Ciftci AO, Senocak ME, Büyükpamukçu N, Hiçsönmez A (1999). "Gastric outlet obstruction due to corrosive ingestion: incidence and outcome". Pediatr. Surg. Int. 15 (2): 88–91. doi:10.1007/s003830050523. PMID 10079337.
  5. ↑ 5.0 5.1 Miner PB, Harri JE, McPhee MS (1982). "Intermittent gastric outlet obstruction from a pedunculated gastric polyp". Gastrointest. Endosc. 28 (3): 219–20. PMID 7129059.
  6. ↑ Gencosmanoglu R, Sen-Oran E, Kurtkaya-Yapicier O, Tozun N (2003). "Antral hyperplastic polyp causing intermittent gastric outlet obstruction: case report". BMC Gastroenterol. 3: 16. doi:10.1186/1471-230X-3-16. PMC 166166. PMID 12831404.
  7. ↑ Zargar SA, Kochhar R, Nagi B, Mehta S, Mehta SK (1989). "Ingestion of corrosive acids. Spectrum of injury to upper gastrointestinal tract and natural history". Gastroenterology. 97 (3): 702–7. PMID 2753330.
  8. ↑ 8.0 8.1 Taylor SM, Adams DB, Anderson MC (1991). "Duodenal stricture: a complication of chronic fibrocalcific pancreatitis". South. Med. J. 84 (3): 338–41. PMID 2000520.
  9. ↑ Menke DM, Kyle RA, Fleming CR, Wolfe JT, Kurtin PJ, Oldenburg WA (1993). "Symptomatic gastric amyloidosis in patients with primary systemic amyloidosis". Mayo Clin. Proc. 68 (8): 763–7. PMID 8331978.
  10. ↑ Friedman S, Janowitz HD (1998). "Systemic amyloidosis and the gastrointestinal tract". Gastroenterol. Clin. North Am. 27 (3): 595–614, vi. PMID 9891699.
  11. ↑ Khan S, Orenstein SR (2000). "Eosinophilic gastroenteritis masquerading as pyloric stenosis". Clin Pediatr (Phila). 39 (1): 55–7. doi:10.1177/000992280003900109. PMID 10660821.
  12. ↑ Chaudhary R, Shrivastava RK, Mukhopadhyay HG, Diwan RN, Das AK (2001). "Eosinophilic gastritis--an unusual cause of gastric outlet obstruction". Indian J Gastroenterol. 20 (3): 110. PMID 11400803.
  13. ↑ Tursi A, Rella G, Inchingolo CD, Maiorano M (2007). "Gastric outlet obstruction due to gastroduodenal eosinophilic gastroenteritis". Endoscopy. 39 Suppl 1: E184. doi:10.1055/s-2006-945125. PMID 17614041.
  14. ↑ Chen MJ, Chu CH, Lin SC, Shih SC, Wang TE (2003). "Eosinophilic gastroenteritis: clinical experience with 15 patients". World J. Gastroenterol. 9 (12): 2813–6. PMC 4612059. PMID 14669340.
  15. ↑ Lee CM, Changchien CS, Chen PC, Lin DY, Sheen IS, Wang CS, Tai DI, Sheen-Chen SM, Chen WJ, Wu CS (1993). "Eosinophilic gastroenteritis: 10 years experience". Am. J. Gastroenterol. 88 (1): 70–4. PMID 8420276.
  16. ↑ Aranha GV, Prinz RA, Greenlee HB, Freeark RJ (1984). "Gastric outlet and duodenal obstruction from inflammatory pancreatic disease". Arch Surg. 119 (7): 833–5. PMID 6732492.
  17. ↑ Agrawal NM, Gyr N, McDowell W, Font RG (1974). "Intestinal obstruction due to acute pancreatitis. Case report and review of literature". Am J Dig Dis. 19 (2): 179–85. PMID 4811173.
  18. ↑ Bradley EL (1989). "Complications of chronic pancreatitis". Surg. Clin. North Am. 69 (3): 481–97. PMID 2658160.
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  21. ↑ Johnson FE, Humbert JR, Kuzela DC, Todd JK, Lilly JR (1975). "Gastric outlet obstruction due to X-linked chronic granulomatous disease". Surgery. 78 (2): 217–23. PMID 807981.
  22. ↑ Mulholland MW, Delaney JP, Simmons RL (1983). "Gastrointestinal complications of chronic granulomatous disease: surgical implications". Surgery. 94 (4): 569–75. PMID 6623357.
  23. ↑ Huang A, Abbasakoor F, Vaizey CJ (2006). "Gastrointestinal manifestations of chronic granulomatous disease". Colorectal Dis. 8 (8): 637–44. doi:10.1111/j.1463-1318.2006.01030.x. PMID 16970572.
  24. ↑ Bakken DA, Abramo TJ (1997). "Gastric lactobezoar: a rare cause of gastric outlet obstruction". Pediatr Emerg Care. 13 (4): 264–7. PMID 9291515.
  25. ↑ De Backer A, Van Nooten V, Vandenplas Y (1999). "Huge gastric trichobezoar in a 10-year-old girl: case report with emphasis on endoscopy in diagnosis and therapy". J. Pediatr. Gastroenterol. Nutr. 28 (5): 513–5. PMID 10328129.
  26. ↑ Phillips MR, Zaheer S, Drugas GT (1998). "Gastric trichobezoar: case report and literature review". Mayo Clin. Proc. 73 (7): 653–6. doi:10.1016/S0025-6196(11)64889-1. PMID 9663194.
  27. ↑ 27.0 27.1 White NB, Gibbs KE, Goodwin A, Teixeira J (2003). "Gastric bezoar complicating laparoscopic adjustable gastric banding, and review of literature". Obes Surg. 13 (6): 948–50. doi:10.1381/096089203322618849. PMID 14738689.
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  29. ↑ Amarapurkar DN, Patel ND, Amarapurkar AD (2003). "Primary gastric tuberculosis--report of 5 cases". BMC Gastroenterol. 3: 6. PMC 155648. PMID 12703983.
  30. ↑ Rao YG, Pande GK, Sahni P, Chattopadhyay TK (2004). "Gastroduodenal tuberculosis management guidelines, based on a large experience and a review of the literature". Can J Surg. 47 (5): 364–8. PMC 3211943. PMID 15540690.
  31. ↑ Padussis J, Loffredo B, McAneny D (2005). "Minimally invasive management of obstructive gastroduodenal tuberculosis". Am Surg. 71 (8): 698–700. PMID 16217956.
  32. ↑ Di Placido R, Pietroletti R, Leardi S, Simi M (1996). "Primary gastroduodenal tuberculous infection presenting as pyloric outlet obstruction". Am. J. Gastroenterol. 91 (4): 807–8. PMID 8677960.
  33. ↑ Subei I, Attar B, Schmitt G, Levendoglu H (1987). "Primary gastric tuberculosis: a case report and literature review". Am. J. Gastroenterol. 82 (8): 769–72. PMID 3605037.
  34. ↑ Kreel L, Ellis H (1965). "Pyloric stenosis in adults: A clinical and radiological study of 100 consecutive patients". Gut. 6 (3): 253–61. PMC 1552275. PMID 18668780.
  35. ↑ Gheorghe L, Băncilă I, Gheorghe C, Herlea V, Vasilescu C, Aposteanu G (2002). "Antro-duodenal tuberculosis causing gastric outlet obstruction--a rare presentation of a protean disease". Rom J Gastroenterol. 11 (2): 149–52. PMID 12145672.
  36. ↑ Adebamowo CA, Oduntan O (1999). "Duodenal web causing gastric outlet obstruction in an adult". West Afr J Med. 18 (1): 73–4. PMID 10876738.
  37. ↑ 37.0 37.1 Urayama S, Kozarek R, Ball T, Brandabur J, Traverso L, Ryan J, Wechter D (1995). "Presentation and treatment of annular pancreas in an adult population". Am. J. Gastroenterol. 90 (6): 995–9. PMID 7771437.
  38. ↑ Johnson CD (1995). "Gastric outlet obstruction malignant until proved otherwise". Am. J. Gastroenterol. 90 (10): 1740. PMID 7572886.
  39. ↑ 39.0 39.1 Shone DN, Nikoomanesh P, Smith-Meek MM, Bender JS (1995). "Malignancy is the most common cause of gastric outlet obstruction in the era of H2 blockers". Am. J. Gastroenterol. 90 (10): 1769–70. PMID 7572891.
  40. ↑ 40.0 40.1 Johnson CD, Ellis H (1990). "Gastric outlet obstruction now predicts malignancy". Br J Surg. 77 (9): 1023–4. PMID 2207566.
  41. ↑ 41.0 41.1 Tendler DA (2002). "Malignant gastric outlet obstruction: bridging another divide". Am. J. Gastroenterol. 97 (1): 4–6. doi:10.1111/j.1572-0241.2002.05391.x. PMID 11808968.
  42. ↑ Jeong HY, Yang HW, Seo SW, Seong JK, Na BK, Lee BS, Song GS, Park HS, Lee HY (2002). "Adenocarcinoma arising from an ectopic pancreas in the stomach". Endoscopy. 34 (12): 1014–7. doi:10.1055/s-2002-35836. PMID 12471549.
  43. ↑ Emerson L, Layfield LJ, Rohr LR, Dayton MT (2004). "Adenocarcinoma arising in association with gastric heterotopic pancreas: A case report and review of the literature". J Surg Oncol. 87 (1): 53–7. doi:10.1002/jso.20087. PMID 15221920.
  44. ↑ Roy PK, Venzon DJ, Shojamanesh H, Abou-Saif A, Peghini P, Doppman JL, Gibril F, Jensen RT (2000). "Zollinger-Ellison syndrome. Clinical presentation in 261 patients". Medicine (Baltimore). 79 (6): 379–411. PMID 11144036.
  45. ↑ Nugent FW, Roy MA (1989). "Duodenal Crohn's disease: an analysis of 89 cases". Am. J. Gastroenterol. 84 (3): 249–54. PMID 2919581.
  46. ↑ Kefalas CH (2003). "Gastroduodenal Crohn's disease". Proc (Bayl Univ Med Cent). 16 (2): 147–51. PMC 1201000. PMID 16278730.
  47. ↑ Matsui T, Hatakeyama S, Ikeda K, Yao T, Takenaka K, Sakurai T (1997). "Long-term outcome of endoscopic balloon dilation in obstructive gastroduodenal Crohn's disease". Endoscopy. 29 (7): 640–5. doi:10.1055/s-2007-1004271. PMID 9360875.
  48. ↑ Fitzgibbons TJ, Green G, Silberman H, Eliasoph J, Halls JM, Yellin AE (1980). "Management of Crohn's disease involving the duodenum, including duodenal cutaneous fistula". Arch Surg. 115 (9): 1022–8. PMID 6106466.
  49. ↑ Green ST, Drury JK, McCallion J, Erwin L (1987). "Carcinoid tumour presenting as recurrent gastric outlet obstruction: a case of long-term survival". Scott Med J. 32 (2): 54–5. doi:10.1177/003693308703200212. PMID 3602991.
  50. ↑ Chowdhury A, Dhali GK, Banerjee PK (1996). "Etiology of gastric outlet obstruction". Am. J. Gastroenterol. 91 (8): 1679. PMID 8759707.
  51. ↑ Cappell MS, Davis M (2006). "Characterization of Bouveret's syndrome: a comprehensive review of 128 cases". Am. J. Gastroenterol. 101 (9): 2139–46. doi:10.1111/j.1572-0241.2006.00645.x. PMID 16817848.
  52. ↑ Dubois A, Price SF, Castell DO (1978). "Gastric retention in peptic ulcer disease. A reappraisal". Am J Dig Dis. 23 (11): 993–7. PMID 717362.
  53. ↑ Hangen D, Maltz GS, Anderson JE, Knauer CM (1989). "Marked hypergastrinemia in gastric outlet obstruction". J. Clin. Gastroenterol. 11 (4): 442–4. PMID 2760432.
  54. ↑ Lau JY, Chung SC, Sung JJ, Chan AC, Ng EK, Suen RC, Li AK (1996). "Through-the-scope balloon dilation for pyloric stenosis: long-term results". Gastrointest. Endosc. 43 (2 Pt 1): 98–101. PMID 8635729.
  55. ↑ Awan A, Johnston DE, Jamal MM (1998). "Gastric outlet obstruction with benign endoscopic biopsy should be further explored for malignancy". Gastrointest. Endosc. 48 (5): 497–500. PMID 9831838.
  56. ↑ 56.0 56.1 Goldstein H, Boyle JD (1965). "The saline load test--a bedside evaluation of gastric retention". Gastroenterology. 49 (4): 375–80. PMID 5831782.

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