Gastric outlet obstruction with benign endoscopic biopsy should be further explored for malignancy

Gastric dysplasia signifies the presence of atypical cells in the gastric mucosa, which have not invaded beyond the lamina propria, and it rarely leads to tissue growth large enough to cause gastric outlet obstruction (GOO) to the gastric contents. However, GOO is commonly observed as a first clinical manifestation of advanced invasive gastric cancer in developing countries where patients seek medical care late. The present case highlights the treatment journey of a young woman who presented to us with features of GOO. Her endoscopic and radiological findings revealed a nodular gastric antral thickening causing GOO. An endoscopic biopsy showed features of dysplasia. She underwent distal gastrectomy following discussion in a multidisciplinary tumour board. Histopathological examination of the gastrectomy specimen confirmed dysplasia without any invasion beyond lamina. To the best of our knowledge, this is perhaps the first report of dysplasia of the stomach presenting as GOO.

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Intramural Duodenal Hematoma Complicating Endoscopic Biopsy Presenting With Gastric Outlet Obstruction and Acute Pancreatitis

The American Journal of Gastroenterology ◽

10.14309/00000434-201710001-01816 ◽

2017 ◽

Vol 112 ◽

pp. S995

Author(s):

Mahmud Samra ◽

Tarek Almouradi ◽

Charles Berkelhammer

Keyword(s):

Acute Pancreatitis ◽

Gastric Outlet Obstruction ◽

Outlet Obstruction ◽

Endoscopic Biopsy ◽

Duodenal Hematoma

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A rare case of primary gastric tuberculosis presenting as gastric outlet obstruction mimicking malignancy

International Journal of Scientific Reports ◽

10.18203/issn.2454-2156.intjscirep20184194 ◽

2018 ◽

Vol 4 (10) ◽

pp. 263

Author(s):

Kanika Singh ◽

Sujata Raychaudhuri ◽

Sheetal Gole ◽

Anu Aggarwal

Keyword(s):

Weight Loss ◽

Differential Diagnosis ◽

Gastric Outlet Obstruction ◽

Epigastric Pain ◽

Outlet Obstruction ◽

Rare Condition ◽

Surgical Excision ◽

Giant Cells ◽

Endoscopic Biopsy ◽

Gastric Tuberculosis

<p>Gastric tuberculosis (TB), both primary and secondary is a rare condition. It is less common in immunocompetent individuals and in those without any antecedent pulmonary infection. The nonspecific complaints like epigastric pain, vomiting and weight loss may be confounding and lead to difficulty in diagnosis and differential diagnosis may include adenocarcinoma. We present a case of an immunocompetent male who presented with the above mentioned symptoms and on endoscopy showed an ulcerated region in the pyloric antrum with gastric outlet obstruction. A differential diagnosis of adenocarcinoma was suggested by the clinician. The endoscopic biopsy revealed granulomas and giant cells with no evidence of dysplasia. However, Ziehl-Neelson stain for acid fast bacilli was negative. The diagnosis of gastric tuberculosis was confirmed on Polymerase chain reaction (PCR) test for TB. A possibility of gastric tuberculosis should always be kept in mind in an endemic country like India with nonspecific abdominal complaints like epigastric pain, weight loss, vomiting etc. along with other differential diagnosis. A correct clinicopathological diagnosis would help in the appropriate treatment of the patient and would prevent unnecessary surgical excision.</p>

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Gastric Outlet Obstruction due to Intramural Duodenal Hematoma after Endoscopic Biopsy: Possible Therapeutic Role of Endoscopic Dilation

Case Reports in Gastroenterology ◽

10.1159/000494967 ◽

2018 ◽

Vol 12 (3) ◽

pp. 692-698

Author(s):

Mahmud Samra ◽

Tarek Al-Mouradi ◽

Charles Berkelhammer

Keyword(s):

Abdominal Pain ◽

Gastric Outlet Obstruction ◽

Rare Complication ◽

Outlet Obstruction ◽

Abdominal Ultrasound ◽

Endoscopic Biopsy ◽

Duodenal Hematoma ◽

Bowel Rest ◽

Diagnostic Modalities ◽

Duodenal Lumen

Intramural duodenal hematoma (IDH) is an extremely rare complication after endoscopic biopsy. It typically presents with symptoms due to duodenal obstruction, which include abdominal pain and bilious vomiting. The hematoma may also expand and cause ampullary compression leading to pancreatitis and cholestasis. Computed tomography scan and abdominal ultrasound are the most common diagnostic modalities. Treatment is usually conservative, with bowel rest, nasogastric suctioning and total parenteral nutrition. Refractory cases have been described, requiring endoscopic therapy or surgical drainage. We describe a 28-year-old healthy male who presented with acute abdominal pain a few hours after a routine esophagogastrodudenoscopy with biopsies was performed. Following an otherwise uneventful endoscopy, he developed a gastric outlet obstruction and pancreatitis secondary to an IDH. The patient was managed conservatively. Resolution of his gastric outlet obstruction occurred immediately after gentle passage of the endoscope through the narrowed duodenal lumen.

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EUS-GUIDED GASTROENTEROSTOMY (EUS-GE) FOR TREATMENT OF MALIGNAT GASTRIC OUTLET OBSTRUCTION (GOO); FIRST NORWEGIAN EXPERIENCE

10.1055/s-0038-1637405 ◽

2018 ◽

Author(s):

KDC Pham ◽

R Flesland Havre

Keyword(s):

Gastric Outlet Obstruction ◽

Outlet Obstruction

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Temporal Trends of Peptic Ulcer Disease in Kashmir, India

JMS SKIMS ◽

10.33883/jms.v15i2.251 ◽

2012 ◽

Vol 15 (2) ◽

pp. 136-140

Author(s):

G M Gulzar ◽

Showkat A Zargar ◽

Muzaffar Nazir ◽

Gul Javid ◽

Bashir A Khan ◽

...

Keyword(s):

Peptic Ulcer ◽

Peptic Ulcer Disease ◽

Gastric Outlet Obstruction ◽

Temporal Trends ◽

Outlet Obstruction ◽

Life Time ◽

Point Prevalence ◽

Asymptomatic Group ◽

Ulcer Disease ◽

Ulcer Perforation

BACKGROUND: Since late 1960s, the prevalence of peptic ulcer disease and its complications has been steadily decreasing. OBJECTIVE: To ascertain the changing trends in the prevalence and complications of peptic ulcer in Kashmir. METHODS: A cohort of 10474 people aged 15-60 years in district Baramulla of Kashmir was interviewed about symptoms, complications, and surgery related to peptic ulcer. People were enquired about smoking, use of NSAIDs, H2 Receptor antagonists, proton pump inhibitors and endoscopies. All symptomatic and randomly selected group of asymptomatic people underwent esophago-gastro-cluodenoscopy. RESULTS: In symptomatic group, 286 (41.45%) people hod peptic ulcer and in asymptomatic group 24 (5.35%) had peptic ulcer. There were 71 already diagnosed cases of peptic ulcer; totaling 381. Thirty three people had surgery for peptic ulcer. The point prevalence of peptic ulcer was 3.54% and lifetime prevalence 8.96%. The highest prevalence was in 4th decade. Bleeding was seen in 23.63%, gastric outlet obstruction 4.20%, ulcer perforation 0.52%. 9.39% of peptic ulcer patients had undergone surgery. When compared to previous study in 1985 in Kashmir, there was decrease in point prevalence of 25%, in life-time prevalence of 20.14%, Gastric outlet obstruction by 51.7%, ulcer perforation by 87%, surgery rate by 60% and bleeding by a marginal 2%. CONCLUSION: Prevalence of peptic ulcerand its complications (except bleeding) are showing downward trend in Kashmir over the last 20 years. JMS 2012;15(2):136-40

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