scholarly journals Laparoscopic Gastrojejunostomy for the Treatment of SIRT-Induced Duodenal Ulcer Complicated by Gastric Outlet Obstruction

2021 ◽  
Author(s):  
Walaa El Arja ◽  
Sarah B. Eid ◽  
Elias Saikaly ◽  
Lynn Ezzeddine ◽  
Rayan Daoud ◽  
...  
Keyword(s):  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Stage Iv ◽  
Therapeutic Modality ◽  
Laparoscopic Gastrojejunostomy ◽  
Stage Iv Breast Cancer ◽  
Gastrointestinal Ulcer ◽  
History Of ◽  
Radiation Induced ◽  
Exacerbation Of Symptoms

AbstractSelective internal radiation therapy (SIRT) is an emerging therapeutic modality in patients with unresectable hepatocellular carcinoma or liver metastases. However, complications can occur due to migration of radiation microspheres such as gastrointestinal ulcer, cholecystitis, bleeding, pancreatitis, and many others. A 50-year-old woman with stage IV breast cancer who underwent radioembolization for unresectable hepatic metastasis 6 months ago presented to our hospital with 1 month history of nausea, vomiting, with food intolerance, and weight loss. Esophagogastroduodenoscopy showed large deep duodenal bulbar ulcer along with antral ulcerations and edematous gastropathy. Biopsies revealed typical black, duodenal yttrium-90 sphere, documenting radiation injury. After she was discharged on proton pump inhibitor, the patient came back 1 month later for exacerbation of symptoms; computed tomography scan of the abdomen showed gastric outlet obstruction. Although there is no consensus in treating radiation-induced ulcers, physicians should be aware of this complication in patient who underwent SIRT presenting for abdominal pain.

scholarly journals Unusual Tissue – Unusual Issue: Pancreatic Heterotopia Presenting as Gastric Outlet Obstruction

2021 ◽  
pp. 338-343
Author(s):  
Thu L. Nguyen ◽  
Shivani Kapur ◽  
Stephen C. Schlack-Haerer ◽  
Grzegorz T. Gurda ◽  
Milan E. Folkers
Keyword(s):  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Needle Aspiration ◽  
Pancreatic Tissue ◽  
Cystic Mass ◽  
Pancreatic Heterotopia ◽  
History Of

Pancreatic heterotopia (PH) is a common, but typically small (<1 cm), incidental and asymptomatic finding; however, PH should be considered even for large and symptomatic upper gastrointestinal masses. A 27-year-old white woman presented with a 3-week history of burning epigastric pain, nausea, early satiety, and constipation. Physical examination revealed epigastric and right upper quadrant tenderness with normal laboratory workup, but imaging revealed a 5-cm, partly cystic mass arising from the gastric antrum with resulting pyloric stenosis and partial gastric outlet obstruction. Endoscopic ultrasound-guided fine needle aspiration revealed PH – an anomalous pancreatic tissue lying in a nonphysiological site. The patient ultimately underwent a resection and recovered uneventfully, with a complete pathologic examination revealing normal exocrine pancreatic tissue (PH type 2) without malignant transformation. We report a case of heterotopic pancreas manifesting as severe gastric outlet obstruction, in addition to a thorough diagnostic workup and surgical follow-up, in a young adult. Differential diagnoses and features that speak to benignity of a large, symptomatic mass lesion (PH in particular) are discussed.

Bouveret syndrome: a rare cause of gastric outlet obstruction

2021 ◽  
Vol 14 (4) ◽  
pp. e240236
Author(s):  
Christopher Smith ◽  
Shailendra Singh ◽  
Paul Vulliamy ◽  
Samrat Mukherjee
Keyword(s):  
Abdominal Pain ◽  
Gastric Outlet Obstruction ◽  
Gallstone Disease ◽  
Outlet Obstruction ◽  
Chronic Cholecystitis ◽  
Fistula Formation ◽  
Bladder Drainage ◽  
Blood Tests ◽  
History Of ◽  
Bouveret Syndrome

Bouveret syndrome is a rare cause of gastric outlet obstruction. It is characterised by the presence of an obstructing gallstone in the pylorus or proximal duodenum, which has travelled to its obstructing position via an acquired fistula. Our case involves a 73-year-old man presenting to the acute surgical take with a 2-day history of right-sided abdominal pain and vomiting. His medical history included perforated cholecystitis treated with antibiotics and percutaneous gall bladder drainage, 1 year earlier. Examination and blood tests were suggestive of gastric outlet obstruction. CT abdomen and pelvis demonstrated a large gallstone obstructing the duodenum, confirming a diagnosis of Bouveret syndrome. The patient improved following gastrolithotomy, and was discharged 2 weeks postoperatively. Fistula formation is a complication of chronic cholecystitis and therefore Bouveret syndrome should be considered in patients with a background of gallstone disease presenting with gastric outlet obstruction.

scholarly journals Gastric outlet obstruction with an elevated serum pancreatic lipase secondary to an infraumbilical hernia

2013 ◽  
Vol 95 (7) ◽  
pp. e16-e18
Author(s):  
WKB Ranasinghe ◽  
M Smith
Keyword(s):  
Ventral Hernia ◽  
Gastric Outlet Obstruction ◽  
Pancreatic Lipase ◽  
Elevated Serum ◽  
Outlet Obstruction ◽  
Serum Biochemistry ◽  
Uneventful Recovery ◽  
Large Ventral Hernia ◽  
History Of ◽  
Symptoms And Signs

We report the case of a 68-year-old woman who presented with symptoms and signs of gastric outlet obstruction with a history of a ventral hernia. Clinical examination revealed a large ventral hernia with visible peristalsis of the herniated viscera.Initial serum biochemistry revealed a markedly elevated lipase level and deranged renal function.Computed tomography demonstrated an infraumbilical hernia with herniation of the stomach through the ventral defect and distortion of the pancreatic anatomy. The hernia was reduced operatively and repaired, leading to an uneventful recovery.

scholarly journals Rapunzel syndrome causing partial gastric outlet obstruction requiring emergency laparotomy

2020 ◽  
Vol 13 (1) ◽  
pp. e232904
Author(s):  
Robert Lyons ◽  
Granit Ismaili ◽  
Michael Devine ◽  
Haroon Malik
Keyword(s):  
Ct Scan ◽  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Postoperative Recovery ◽  
Emergency Laparotomy ◽  
Rapunzel Syndrome ◽  
History Of

A 16-year-old girl with a background of childhood trichophagia presented with a 2-day history of epigastric pain and associated anorexia with vomiting. An epigastric mass was palpable on examination. A CT scan revealed an intragastric trichobezoar, extending into the duodenum consistent with Rapunzel syndrome with evidence of partial gastric outlet obstruction and a possible perforation. The patient underwent an urgent laparotomy and extraction of the trichobezoar. The bezoar was removed without complication and no intraoperative evidence of perforation was detected. After an uncomplicated postoperative recovery, she was discharged home with psychiatric follow-up.

scholarly journals Laparoscopic gastrojejunostomy for gastric outlet obstruction in patients with unresectable hepatopancreatobiliary cancers: A personal series and systematic review of the literature

2018 ◽  
Vol 24 (18) ◽  
pp. 1978-1988 ◽  
Author(s):  
Alba Manuel-Vázquez ◽  
Raquel Latorre-Fragua ◽  
Carmen Ramiro-Pérez ◽  
Aylhin López-Marcano ◽  
Roberto De la Plaza-Llamas ◽  
...  
Keyword(s):  
Systematic Review ◽  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Review Of The Literature ◽  
Laparoscopic Gastrojejunostomy

Comparison of Treatment Outcomes of Endoscopic Stenting and Laparoscopic Gastrojejunostomy for Malignant Gastric Outlet Obstruction

2018 ◽  
Vol 84 (6) ◽  
pp. 991-995 ◽  
Author(s):  
Shuai Leiyuan ◽  
Xu Jianli ◽  
Zhao Zhengzhong ◽  
Ji Guangyan ◽  
Zhu Dailiang
Keyword(s):  
Hospital Stay ◽  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Length Of Hospital Stay ◽  
Operation Time ◽  
Laparoscopic Group ◽  
Endoscopic Stenting ◽  
Stent Group ◽  
Malignant Gastric Outlet Obstruction ◽  
Laparoscopic Gastrojejunostomy

To compare the clinic outcomes of endoscopic stenting and laparoscopic gastrojejunostomy (LGJ) for patients with malignant gastric outlet obstruction (GOO). We retrospectively reviewed 63 patients with malignant GOO that underwent endoscopic stenting [Stent Group (SG), n = 29] or LGJ [Laparoscopic Group (LG), n = 34]. Then, we evaluated the medical effects, postoperative hospital stay, and hospitalization expenses in both groups. Compared to LG, SG has a shorter operation time [SG: (41.1 ± 9.3) minutes vs LG: (137.4 ± 21.7) minutes, P = 0.000], less intra-operative blood loss [(23.7 ± 9.0) mL vs (121.1 ± 24.3) mL, P = 0.000], relatively lower hospitalization expenses [(2272.7 ± 413.9) $ vs (5182.4 ± 517.3) $, P = 0.000]. Besides, the median intake time was significantly shorter in the SG than that in the LG [(0.9 ± 0.3) days vs (4.1 ± 0.6) days, P = 0.000]. However, there were no significant differences between SG with LG in surgical success rate (100 vs 100%, P = 1.000), length of hospital stay [(6.1 ± 3.3) days vs (10.9 ± 4.7) days, P = 0.422], recurrent obstructive rate (37.9 vs 26.5%, P = 0.949) and median survivals [(141.4 ± 81.4) days vs (122.7 ± 88.8) days, P = 0.879]. Endoscopic stenting and LGJ are both relatively safe and effective treatments for patients with malignant GOO. But we suggest that endoscopic stenting should be considered first in patients with malignant GOO because it has many advantages over LGJ.

Laparoscopic Gastrojejunostomy for Patients with Unresectable Gastric Cancer with Gastric Outlet Obstruction

2017 ◽  
Vol 21 (8) ◽  
pp. 1220-1225 ◽  
Author(s):  
Toshiyasu Ojima ◽  
Mikihito Nakamori ◽  
Masaki Nakamura ◽  
Masahiro Katsuda ◽  
Keiji Hayata ◽  
...  
Keyword(s):  
Gastric Cancer ◽  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Laparoscopic Gastrojejunostomy ◽  
Unresectable Gastric Cancer
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