Obstructing Gastroduodenal Ulcers

Kozoll, Donald D.; Mittelpunkt, Allen I.; Meyer, Karl

doi:10.1001/archsurg.1965.01320150061009

Cited by 7 publications

(7 citation statements)

References 10 publications

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“…The series of Donald D Kozoll & Karl A Meyer [10] also showed the same pattern with non-skilled day labourer group listed most frequently with obstruction.…”

Section: Discussion:-supporting

confidence: 53%

Etiological profile of gastric outlet obstruction and its treatment: a hospital based prospective study in a tertiary care center, north-east India.

Singha¹,

Pawar.²,

Mazuder.³

et al. 2017

IJAR

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“…The series of Donald D Kozoll & Karl A Meyer [10] also showed the same pattern with non-skilled day labourer group listed most frequently with obstruction.…”

Section: Discussion:-supporting

confidence: 53%

Etiological profile of gastric outlet obstruction and its treatment: a hospital based prospective study in a tertiary care center, north-east India.

Singha¹,

Pawar.²,

Mazuder.³

et al. 2017

IJAR

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“…Men outnumbered women by 5.25:1 as compared to 5.5:1 observed by Yogi Ram and Chowdhary [10] Personal history in present series 52% of the patients were manual labourers who gave a history of irregular diet habits, which seemed to contribute to disease process. The series of Donald D. Kozoll and Karl A. Meyer [11] also showed the same pattern with the non-skilled day labourer group listed most frequently with obstruction.…”

Section: Age Distribution and Sex Incidencesupporting

confidence: 53%

“…Of the 50 cases in our study gastric outlet obstruction 26(52%) had carcinoma antrum, 23(46%) had cicatrized duodenal ulcer and 01 had gastric outlet obstruction secondary to corrosive ingestion. Malignancy is the commonest cause of gastric outlet obstruction even in a developing country like India, Similar cause for gastric outlet obstruction seen in the studies of Misra et al, [10,5] Shone DN et al, [11,6] .…”

Section: Causes Of Gastric Outlet Obstructionmentioning

confidence: 68%

Gastric outlet obstruction, a clinical study in tertiary care hospital South India

P¹,

P²,

Vasudevaiah³

2019

Int. J. Surg. Sci.

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Background: Gastric Outlet Obstruction implies complete or incomplete obstruction of the distal stomach, pylorus or proximal duodenum. Gastric outlet obstruction is not a single entity; it is the clinical and pathophysiological consequence of any disease process that produces a mechanical impediment to gastric emptying. Now in the era of H2 blockers and proton pump inhibitors, incidence of duodenal ulcer producing gastric outlet obstruction has been decreasing as symptomatic ulcer begin to respond to medical treatment, and at the same time the incidence of antral carcinoma of stomach producing gastric outlet obstruction has comparatively increased, which may be due to increased early diagnosis of the condition with the help of flexible fibre optic endoscope. Methods: An elaborate study of these cases with regard to the history, clinical features, routine and special investigations, pre-operative treatment, operative findings, post-operative management and complications in post-operative period is done. Results: Of the 50 cases of gastric outlet obstruction 26 had carcinoma antrum (52%), 23 had cicatrized duodenal ulcer (46%) and 1 had gastric outlet obstruction secondary to corrosive ingestion. The age incidence of the patients in this study ranged from 22 -84 years with a mean of 53.62 years. In case of obstruction secondary to duodenal ulcer the maximum age incidence is between 31-40 years. The maximum age incidence of gastric outlet obstruction due to carcinoma antrum is 61-70 years. In this series, 42 patients (84%) were males and 8 patients (16%) were female. Male to female ratio (M:F) is 5.25:1. M: F ratio in cicatrized duodenal ulcer is 10.5:1 and in carcinoma antrum is 3.33:1. 52% of the patients were manual labourers who gave a history of irregular diet habits. 68% of patients had history of smoking and 66% had history of alcohol intake. Postprandial vomiting and epigastria pain are the main symptoms (96%) in this series. Other symptoms included anorexia (84%), weight loss (72%), post prandial Epigastric fullness (68%), haematemesis (24%), melena (64%) and constipation (48%). Pallor was present in 56% and dehydration in 62%. Blood group 'O' was common in cicatrized duodenal ulcer patients (52.18%) whereas blood group 'A' was common in malignant cases (50%). Conclusions: Number of cases with cicatrized duodenal ulcer as the chief etiological factor for gastric outlet obstruction is diminishing and the number of cases of antral carcinoma of stomach as the cause of gastric outlet obstruction is increasing. Upper Gastro intestinal endoscopy should be mandatory in all suspected cases of gastric outlet obstruction. It can diagnose the cause of obstruction very effectively than any other investigative modality. Effective treatment in carcinoma stomach depends on early diagnosis.

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“…The total number of adult cases of gastric outlet obstruction in this study was 30. This consisted of Gastric outlet obstruction secondary to cicatrised duodenal ulcer (21) and gastric outlet obstruction secondary to malignancy (9).…”

Section: Resultsmentioning

confidence: 99%

“…The series of Donald D. Kozoll and Karl A. Meyer also showed the same pattern with the non-skilled day labourer group listed most frequently with obstruction. 9 The duration of pain was from 3 months to 6 months with a median of 4 months 17 cases gave history of APD and 2 of them were malignant cases suggesting malignancy developing from gastric ulcer. Anorexia was present in 9 (100%) cases of carcinoma of antrum and in 15 (71.42%) of duodenal ulcer patients.…”

Section: Resultsmentioning

confidence: 99%

A clinical study of gastric outlet obstruction

2016

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Background:From the standpoint of pathology, the term pyloric stenosis is usually inaccurate at least in adult patients, since the site of obstruction is rarely situated at the pylorus itself but, is more often placed immediately proximal to the spinchter where the diagnosis of carcinoma is most probable or more distally in the duodenal bulb where the cause is almost invariably a duodenal ulcer. The aim was to study infantile hypertrophic pyloric stenosis, benign peptic ulcer and gastric carcinoma and evaluation of electrolyte abnormalities in gastric outlet obstruction, to study various modalities of treatment and to assess pertaining to recovery from paralytic ileus. Methods: This was a clinical observational study comprising of 40 cases of gastric outlet obstruction. The patients for this study have been selected from Prathima Institute of Medical Sciences, Karimnagar, Telangana, India from December 2013- November 2015. The cases were selected who were willing to undergo surgery.Results:Congenital hypertrophic pyloric stenosis (CHPS) is more common among first born male infants. Parental consanguinity is associated with increased incidence of congenital hypertrophic pyloric stenosis. CHPS is common in the age group of first 3-6 weeks of life (average 4 weeks). Males are more commonly affected with gastric outlet obstructions in adults. Cicatrized duodenal ulcer is more common in the age group of 30-40 years, while carcinoma stomach is more common in age group of 50-60 years. Vomiting and visible gastric peristalsis are the most common and constant symptom and sign of gastric outlet obstruction, more so in cases of cicatrized duodenal ulcers.Conclusions:Ramstedt’s pyloromyotomy is the gold standard treatment for CHPS. Patients with gastric outlet obstruction due to cicatrized duodenal ulcer require truncal vagotomy with posterior gastrojejunostomy. Vagotomy is optional in view of better response with drugs for APD. Antral carcinoma cases require curative or palliative surgery depending on the stage of the disease.

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Obstructing Gastroduodenal Ulcers

Cited by 7 publications

References 10 publications

Etiological profile of gastric outlet obstruction and its treatment: a hospital based prospective study in a tertiary care center, north-east India.

Etiological profile of gastric outlet obstruction and its treatment: a hospital based prospective study in a tertiary care center, north-east India.

Gastric outlet obstruction, a clinical study in tertiary care hospital South India

A clinical study of gastric outlet obstruction

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