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 Medication Bezoar Causing acute Gastric Outlet Obstruction: A Case Report

2016 ◽  
Vol 33 (3) ◽  
pp. 177-180 ◽  
Author(s):  
Md Abdul Mazid
Keyword(s):  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Uneventful Recovery ◽  
Upper Gastrointestinal Endoscopy ◽  
Abdominal Ultrasonography ◽  
Life Threatening ◽  
History Of ◽  
Upper Gastrointestinal ◽  
Made In

Medication bezoars are rare and are composed of medications and/or medication vehicles. Rarely, medication bezoars can cause serious problems due to complications such as perforation, obstruction, haemorrhage. A 60 years old woman presented with 10 days history of epigastric pain, weakness and postprandial non-bilious vomiting. Her abdominal ultrasonography showed strong post acoustic shadow noted within 1st part of duodenum possibly foreign body. Upper gastrointestinal endoscopy was performed and a bezoar of tablet of aluminum hydroxide was extracted. The patient had uneventful recovery. Acute gastric outlet obstruction is relatively uncommon and mostly due to foreign bodies related to food impaction, with meat being the most frequent culprit. The diagnostic approach to acute gastric outlet obstruction is similar to other cause of GOO. However, therapeutic options differ for each patient. The diagnosis should be made in prompt time to prevent life threatening complications due obstruction and/or effect of medication forming bezoar.J Bangladesh Coll Phys Surg 2015; 33(3): 177-180

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 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 A unusual case of 356 vesical calculii

2012 ◽  
Vol 8 (1) ◽  
pp. 44-47
Author(s):  
A Agarwal ◽  
G Sigdel ◽  
SR KC ◽  
P Shrestha ◽  
WK Belokar
Keyword(s):  
Urinary Tract Infection ◽  
Urinary Tract ◽  
Urinary Bladder ◽  
Tract Infection ◽  
Recurrent Urinary Tract Infection ◽  
Outlet Obstruction ◽  
Upper Urinary Tract ◽  
Uneventful Recovery ◽  
Urinary Bladder Calculi ◽  
History Of

Multiple vesical calculi are rarely seen in urological practice. Males are affected more than the females. Vesical calculi are usually secondary to bladder outlet obstruction. These patients present with recurrent urinary tract infection, haematuria or with retention of urine. We report a 43 years male patient who presented with acute urinary retention. He had history of trauma over perineal region three years back following which he had recurrent urinary tract infection and thinning of stream. USG abdomen revealed normal upper urinary tract with echogenic debris in partially filled urinary bladder. Renal function test was with in normal limit. Per urethral catheterization failed and over antibiotic cover, patient was posted for cystourethroscopy followed by suprapubic cystostomy under spinal anaesthesia. Membranous urethral stricture found during urethroscopy could be managed by optical internal urethrotomy. On cystoscopy whole of bladder was filled with thick pus like material with multiple large urinary bladder calculi. Open cystolithotomy was done and we were surprised to see 356 stones of various size and shape after removal. Patient made uneventful recovery and discharged after 12 days of hospital stay. Journal of College of Medical Sciences-Nepal,2012,Vol-8,No-1, 44-47 DOI: http://dx.doi.org/10.3126/jcmsn.v8i1.6825

scholarly journals Capsule-strip- An Unusual Cause of Acute Gastric Outlet Obstruction: A Case-Report

2013 ◽  
Vol 5 (1) ◽  
pp. 67-68
Author(s):  
AHM Rowshon ◽  
AKM Rafique Uddin
Keyword(s):  
Case Report ◽  
Male Patient ◽  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Pyloric Ring ◽  
Gi Endoscopy ◽  
Blood Tests ◽  
History Of ◽  
Colicky Pain ◽  
Upper Gastrointestinal

A male patient presented with seven days history of severe epigastric colicky pain and vomiting. The patient was anxious and dehydrated. Blood tests and ultrasound reports were unremarkable. . Upper Gastrointestinal (GI) Endoscopy revealed a strip of capsule impacted at pyloric ring which was removed endoscopically and the patient became symptom free. DOI: http://dx.doi.org/10.3329/jssmc.v5i1.16252 J Shaheed Suhrawardy Med Coll, 2013;5(1):67-68

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 An incidental concurrence causing gastric outlet obstruction

2021 ◽  
Vol 8 (8) ◽  
pp. 2505
Author(s):  
Abhirup H. R. ◽  
Priyanka Kenchetty ◽  
Aishwarya K. Chidananda
Keyword(s):  
Duodenal Ulcer ◽  
Peptic Ulcer ◽  
Peptic Ulcer Disease ◽  
Gastric Outlet Obstruction ◽  
Previous History ◽  
Outlet Obstruction ◽  
Exploratory Laparotomy ◽  
Ulcer Disease ◽  
History Of ◽  
Emergency Surgical Intervention

Phytobezoar which is described as an undigested or incompletely digested food. It is an odd cause of gastric outlet obstruction (GOO). The aim of this study is to present and discuss a case of GOO caused by cicatrised duodenal ulcer with a phytobezoar. 71-year-old male, presented with abdominal pain and vomiting (non-bilious) since 3days with peptic ulcer disease for 4 years. Examination and investigations revealed a bezoar requiring emergency surgical intervention. An exploratory laparotomy was conducted. A bezoar was palpated in the stomach and removed through posterior gastrotomy. Vagotomy with Posterior Gastrojejunostomy was done as drainage procedure for cicatrised Duodenal ulcer. GOO caused by phytobezoar can co-exist in patients with previous history of peptic ulcer disease and cicatrised duodenal ulcer. Urgent laparotomy may be indicated.

scholarly journals Successful Emergency Endoscopic Treatment of Gastric Outlet Obstruction due to Gastric Bezoar with Gastric Pneumatosis

2017 ◽  
Vol 11 (3) ◽  
pp. 718-723 ◽  
Author(s):  
Hirokazu Honda ◽  
Takashi Ikeya ◽  
Erika Kashiwagi ◽  
Shuichi Okada ◽  
Katsuyuki Fukuda
Keyword(s):  
Gastric Outlet Obstruction ◽  
Endoscopic Treatment ◽  
Fluid Collection ◽  
Outlet Obstruction ◽  
Serum Lactate ◽  
Rebound Tenderness ◽  
Gastric Bezoar ◽  
History Of ◽  
Upper Abdominal

Gastric bezoars are rare and are usually found incidentally. They can sometimes cause severe complications, including gastric outlet obstruction (GOO) or gastric pneumatosis (GP). In cases of bezoars with GP, the optimal treatment strategy has not yet been defined. We report the case of an 89-year-old man with a history of type 2 diabetes mellitus and hypertension who presented to our emergency room with a 2-day history of upper abdominal pain, nausea, and vomiting. Physical examination revealed no rebound tenderness or guarding, and laboratory values revealed no elevation of the serum lactate level. A computed tomography scan of the abdomen showed a dilated stomach with significant fluid collection, GOO, and GP due to a 42 × 40 mm mass composed of fat and air densities. Emergency esophagogastroduodenoscopy revealed two gastric bezoars, one of which was incarcerated in the pyloric region. We used various endoscopic devices to successfully break and remove the bezoars. We used endoscopic forceps and a water jet followed by an endoscopic snare to cut the bezoars into several pieces and remove them with an endoscopic net. Follow-up endoscopy confirmed that the gastric bezoar had been completely removed. As seen in this case, endoscopic treatment may be a safe and viable option for the extraction of gastric bezoars presenting with GOO and GP.

Hepatic portal vein gas in gastric outlet obstruction

2021 ◽  
Vol 1 (4) ◽  
Author(s):  
Kan Radeesri ◽  
◽  
Suphakarn Techapongsatorn ◽  
Keyword(s):  
Gastric Outlet Obstruction ◽  
Outlet Obstruction ◽  
Abdominal Distension ◽  
Abdominal Radiograph ◽  
Upper Gastrointestinal Endoscopy ◽  
Peptic Ulcer Perforation ◽  
Peptic Ulcers ◽  
History Of ◽  
Hepatic Portal ◽  
Upper Abdomen

A 55-year-old man presented to an emergency department with a history of abdominal pain and vomiting for one week. He had a history of having peptic ulcer perforation surgery. He appeared weak and frustration from pain, abdominal distension at upper abdomen without peritonitis sign on physical examination. Initial abdominal radiograph revealed pneumoperitoneum under both hemidiaphragms with markedly distension of stomach containing food content. Further computed tomography demonstrated evidence of gastric outlet obstruction without intra or extraluminal mass. There is also massive amount of portal venous gas in both lobes of liver. After patient resuscitation with intravenous fluid and nasogastric intubation for gastric decompression, his condition returned to normal, with no sign of peritonitis nor sepsis. Therefore, the upper gastrointestinal endoscopy showed gastric outlet obstruction from chronic peptic ulcers. The endoscopic balloon dilatation of the obstruction part was successful, and he was discharged home with full recovery in one week.

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