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Gastric Outlet Obstruction, Emergency Medicine

Jenny J. Lu Reviewed 06/2017
 


Basics

Description

  • Any process impeding the passage of gastric contents into the duodenum

  • Causes not limited to gastric pathology and may be duodenal or extraluminal in origin

  • Benign and malignant causes...

Diagnosis

Signs and Symptoms

History

  • Symptoms may be intermittent until obstruction becomes complete

  • Nausea and vomiting, usually nonbilious

  • Abdominal pain, variable in character and often vague

  • Early sati...

Treatment

Pre-Hospital

  • Vital signs, airway stabilization, oxygen administration, IV access

  • Fluid resuscitation if dehydrated, vomiting

Initial Stabilization/Therapy

  • 0.9% NS IV fluid resuscitation signific...

Follow-Up

Disposition

Admission Criteria

Most patients with gastric outlet obstruction will be admitted for fluid resuscitation, electrolyte repletion, gastroenterologic, and surgical evaluation. 

Discharge Criteria

Pearls and Pitfalls

  • Misdiagnosing symptoms of gastric outlet obstruction as gastroenteritis

  • Failure to appreciate limitations of plain radiographs in diagnosing this condition

  • Failure to consider gastri...

Additional Reading

  • Dada  SA, Fuhrman  GM. Miscellaneous Disorders and their management in gastric surgery: Volvulus, carcinoid, lymphoma, gastric varices, and gastric outlet obstruction. Surg Clin Nor...

Codes

ICD9

537.0 Acquired hypertrophic pyloric stenosis 

ICD10

K31.1 Adult hypertrophic pyloric stenosis 

SNOMED

  • 13483000 Acquired hypertrophic pyloric stenosis

  • 367403001 Pyloric stenosis (disorder)

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