The Development of Gastric Outlet Obstruction due to a Lumen-occupying Protruding Duodenal Ulcer Mimicking a Submucosal Tumor

Gastric lipomas are rare benign tumors and account for 1-3% of all benign gastric tumors. Majority of the gastric lipomas are asymptomatic and do not demand resection. However, large gastric lipomas may present with upper gastrointestinal bleeding and more rarely gastric outlet obstruction. Traditionally, surgery has been utilized for the management of giant gastric lipomas. More recently, endoscopic techniques are increasingly utilized for the resection of gastric submucosal lesions. Here we describe a case with large gastric lipoma who presented with symptoms suggestive of gastric outlet obstruction. Gastroscopy revealed a large (6 cm) submucosal lesion with a broad peduncle located in antrum. The tumor was prolapsing into duodenum thereby, completing occluding the pylorus. In this case, we performed endoscopic submucosal dissection using a novel, bipolar radiofrequency device. The dissection was completed without any complication.

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A rare cause of gastric outlet obstruction

International Surgery Journal ◽

10.18203/2349-2902.isj20202437 ◽

2020 ◽

Vol 7 (6) ◽

pp. 2062

Author(s):

Abhishek Murali ◽

Rohit Krishnappa ◽

Rajesh B. Murugesh ◽

S. Rajagopalan

Keyword(s):

Duodenal Ulcer ◽

Gastric Outlet Obstruction ◽

Rare Case ◽

Outlet Obstruction ◽

Disease Process ◽

Duodenal Perforation ◽

Provisional Diagnosis ◽

Unique Case ◽

Chronic Duodenal Ulcer ◽

Duodenal Lumen

Gastric outlet obstruction is the clinical and pathophysiological consequence of any disease process that produces mechanical impediment to gastric emptying. It may be acute from inflammatory swelling and peristaltic dysfunction or chronic from cicatrix. Chronic inflammation of the duodenum may lead to recurrent episodes of healing followed by repair and scarring ultimately leading to fibrosis and stenosis of the duodenal lumen. We would like to present a unique case of an elderly lady presenting with intractable vomiting over 3 months, gradually progressive which aggravated on consuming solids initially to consuming liquids later. After thorough investigations a provisional diagnosis of chronic duodenal ulcer with gastric outlet obstruction probably due to cicatrix was made. On laparotomy there was a chronic scarred duodenal ulcer following a previously contained perforation which was causing the gastric outlet obstruction. Cholecystectomy, duodenoplasty and loop gastrojejunostomy was performed with no complications post-operatively. This is a rare case of previous contained duodenal perforation causing gastric outlet obstruction.

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A Rare Case of Gastric Outlet Obstruction due to Large Intramural Duodenal Hematoma Following Endotherapy for Bleeding Duodenal Ulcer in a Patient with End-stage Renal Disease

Journal of Digestive Endoscopy ◽

10.4103/jde.jde_25_17 ◽

2017 ◽

Vol 08 (04) ◽

pp. 199-201

Author(s):

Vineet Kumar Gupta ◽

Ram Chandra Soni

Keyword(s):

Duodenal Ulcer ◽

Renal Disease ◽

Gastric Outlet Obstruction ◽

Rare Case ◽

Outlet Obstruction ◽

Maintenance Hemodialysis ◽

Elderly Male ◽

Duodenal Hematoma ◽

Nasojejunal Feeding ◽

Bleeding Duodenal Ulcer

ABSTRACTWe report a very rare case and probably the first from India of gastric outlet obstruction due to a large intramural duodenal hematoma following combination endotherapy with hemoclipping and injection adrenaline 1:10,000 for actively bleeding duodenal ulcer in an elderly male patient with diabetes, hypertension, and end.stage renal disease on maintenance hemodialysis. The patient improved to approximately 6 weeks of conservative treatment with nasojejunal feeding.

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An incidental concurrence causing gastric outlet obstruction

International Surgery Journal ◽

10.18203/2349-2902.isj20213158 ◽

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.

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