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

Background: Gastric outlet obstruction (GOO) also known as pyloric obstruction is the clinical & patho-physiological consequence of any disease process that produces a mechanical impediment to gastric emptying. Aims & Objectives: To identify the causes, review the modes of clinical presentation and evaluate diagnostic methods & management strategies of GOO in adults. Material & Methods: A prospective observational study conducted in 70 patients attending dept. of surgery, Silchar Medical College and hospital, a tertiary care center during the period of July 2014 to December 2016 of G.O.O. were included in this study. Causes of functional non-mechanical cause of G.O.O were excluded. Only patients of 20 years & above were included in this study. Saline load test, upper gastro-intestinal endoscopy and routine laboratory investigations were done in all cases while Barium meal study was done in few cases to make the diagnosis. Results: Age group of 50-59 was maximum sufferers 40%, followed by age group 40-49 with 30% sufferers. Male-Female ratio was 1.9:1. Antral carcinoma (60%) followed by cicatrized duodenal ulcer seen in 34% of the cases; two case was due to gastric bazoar (3%), one case was due to pseudo-pancreatic cyst and one case was due to carcinoma head of the pancreas. Conclusion: In vast majority of cases, GOO diagnosis can be established clinically. Males are more sufferers and antral carcinoma is main cause of G.O.O. After proper diagnosis, relief can be given to patients by surgical treatment. The type of procedure depends on underlying cause. Abbreviations: GOO-Gastric outlet obstruction, VGP-Visible gastric peristalsis, DU-Duodenal ulcer, CA-Carcinoma.