Causes of Gastric Outlet Obstruction

Arooj Aslam, Zia Arif, Muhammad Umair Hashmi

Abstract


Objective:  This study was conducted to determine various causes of gastric outlet obstruction and frequency of these causes as well.

Design and duration: It is a prospective study. Study was started in January 2017 and completed in December 2017 consisting on one year duration.

Place of study: This study was done on patients admitted in surgical ward of Bahawal Victoria Hospital Bahawalpur. Located in the middle of city. It is a tertiary care hospital.

Patients and Methods: There is a tertiary care hospital B.V Hospital in Bahawalpur city consisting on 1500 beds and dealing with all types of specialties. Which patients presented with gastric outlet obstruction, were included in the study. Only those cases were included which were admitted in a specified period of time. These cases remained admitted for recommended period of time. Which patients left the ward against medical advice they were excluded from the study. Data related to patients was documented on a predesigned proforma containing all necessary related questions such as age of patient, presenting complaint, history of any, malignancy in family, history of any previous disease or taking treatment for any disease now. All investigations of these patients were done in the laboratory of hospital. They were undergone endoscopy of upper GIT. Exploratory laparotomy was done in few patients where all other investigations were non conclusive. C.T scan was done in all patients. Proper consent related to each investigation, procedure or operation was taken from the patient. They were told about the disease, its treatment modalities and prognosis related to each option of treatment. Data was analyzed on Microsoft excel and SPSS version 2007 and presented in the form of tables and charts. Frequency of each etiology was calculated.

Results: Total 60 cases were studied which presented with gastric outlet obstruction. Minimum age of patient was 15 years and maximum age reported was 77 years. Mean age of patients was 53.5 years. Mostly patients were having age above 45 years. It was seen that this disease is less common in young age group. There were 3(5%) cases with age range of 15-25 years, 5(8.3%) with age 26-35 years, 8(13.3%) having age 36-45 years, 20(33.3%) having age 46-55 years, 17(28.3%) cases with age of 56-65 years, 5(8.3%) with age 66-75 years and only 2(3.3%) cases were having age above 75 years. Different causes of gastric outlet obstruction were observed in patients. There were 16 cases with peptic ulcer as a cause of obstruction, in 20 cases gastric carcinoma was present, Duodenal cancer was present in 2 cases, Pancreatic cancer was found in 3 cases, Tuberculosis was found in 3 cases, phytobazoar in 2 cases, diaphragmatic hernia in 2 cases, celiac disease in 2 cases, cholangiocarcinoma in 4 patients and caustic ingestion was cause of gastric outlet obstruction in 3 cases.

Conclusion: Gastric outlet obstruction is much common problem mostly found in old age and most common causes are gastric cancer and peptic ulcer disease. Endoscopic examination is much useful in making diagnosis. Early presentation and early diagnosis of disease may lead to good prognosis.


Keywords


gastric outlet obstruction, causes, gastric cancer, peptic ulcer

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