Abstract

INTRODUCTION: Gastric outlet obstruction is defined as the clinical and patho-physiological consequence of any disease process that produces a mechanical impediment to gastric emptying. The causes of gastric outlet obstruction can be benign or malignant. These obstructions may stem from intrinsic or extrinsic factors. While "pyloric stenosis" is frequently employed to denote the condition, it's somewhat misleading as the obstruction point seldom occurs at the pylorus. With growing awareness of the ailment, shifts in dietary patterns, and the accessibility of medications such as H2 receptor blockers and proton pump inhibitors, the occurrence of peptic ulcers and gastric outlet obstructions is on the decline. METHODS: A prospective study was conducted at the Department of Surgery, M.K.C.G Medical College and Hospital, Berhampur, spanning from January 2023 to January 2024. OBSERVATIONS: The majority of gastric outlet obstruction (GOO) cases presented in the fifth decade of life, followed closely by the sixth decade. Both malignant and benign etiologies were prevalent in this age group. Out of the 40 cases studied, 32 were males and 8 were females, resulting in a male-to-female ratio of 4:1. Vomiting and epigastric pain emerged as the most common symptoms observed in the study. Vomiting was characterized as spontaneous, projectile, and non-bilious among cases of cicatrizing ulcer and stomach carcinoma. Visible gastric peristalsis was observed in 24 cases, accounting for 60% of the total study population. Dehydration was noted in 70% of cases, while anemia was present in 55% of cases. A succession splash was audible in only 45% of cases, and a palpable mass was detected in 22.5% of cases. Truncal vagotomy and gastrojejunostomy were performed in 8 cases of duodenal ulcer, while distal gastrectomy with Billroth-II reconstruction was conducted in 18 cases of stomach carcinoma. The remaining cases of stomach carcinoma were managed through palliative operations. CONCLUSION: This study offers insights into the presentation and aetiology of GOO. Carcinoma of the stomach emerged as the most common cause of GOO in adults, followed by cicatrizing duodenal ulcer. GOO predominantly affected males in the fifth decade of life.

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