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

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.

scholarly journals Endoscopic Diagnosis of Bouveret Syndrome

2020 ◽  
Vol 14 (3) ◽  
pp. 683-686
Author(s):  
Felix Hesse ◽  
Mohamed Abdelhafez ◽  
Christoph Schlag ◽  
Roland M. Schmid ◽  
Tobias Lahmer
Keyword(s):  
Computed Tomography ◽  
Female Patient ◽  
Gastric Outlet Obstruction ◽  
Rare Complication ◽  
Gallstone Ileus ◽  
Duodenal Bulb ◽  
Outlet Obstruction ◽  
Endoscopic Diagnosis ◽  
Endoscopic Imaging ◽  
Bouveret Syndrome

Bouveret syndrome is a form of gallstone ileus and a rare complication of chole(cysto)lithiasis. It describes gastric outlet obstruction secondary to an impacted gallstone. Here, we report a case of an 82-year-old female patient with gastric outlet obstruction and penetration of gallstones into the duodenal bulb on endoscopic imaging. Based on these findings Bouveret syndrome was diagnosed and confirmed by computed tomography.

Gastric dysplasia causing gastric outlet obstruction

2021 ◽  
Vol 14 (7) ◽  
pp. e243208
Author(s):  
Rahul Kumar ◽  
Ipsit Ilahi ◽  
Tripti Prajapati ◽  
Pankaj Kumar Garg
Keyword(s):  
Gastric Outlet Obstruction ◽  
Distal Gastrectomy ◽  
Histopathological Examination ◽  
Outlet Obstruction ◽  
Endoscopic Biopsy ◽  
Tissue Growth ◽  
Radiological Findings ◽  
Gastric Dysplasia ◽  
Gastric Contents ◽  
Atypical Cells

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.

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 Giant Hepatic Hemangioma Presenting as Gastric Outlet Obstruction

2013 ◽  
Vol 98 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Cemalettin Aydin ◽  
Sami Akbulut ◽  
Koray Kutluturk ◽  
Aysegul Kahraman ◽  
Cuneyt Kayaalp ◽  
...  
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Gastric Outlet Obstruction ◽  
Benign Tumor ◽  
Significant Proportion ◽  
Outlet Obstruction ◽  
Left Lobe ◽  
Hepatic Hemangioma ◽  
Giant Hepatic Hemangioma

Abstract Hemangioma, a most frequently encountered primary benign tumor of the liver, is generally determined incidentally during the course of radiologic tests for other reasons. Most lesions are less than 3 cm and a significant proportion of patients are asymptomatic, although the size and location of the lesion in some patients may be associated with the onset of symptoms. Pressure on the stomach and duodenum of giant hemagiomas developing in the left lobe of the liver, in particular, may result in the development of abdominal pain, nausea, vomiting, and feeling bloated, which are characteristic of a gastric outlet obstruction. A 42-year-old man presented with findings of gastric outlet obstruction and weight loss as a result of a giant hepatic hemangioma.

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