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ANKI GI > [13] Gastric Outlet Obstruction > Flashcards

[13] Gastric Outlet Obstruction Flashcards

1
Q

What can cause gastric outlet obstruction?

A

Fibrotic stricturing

Gastric cancer

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2
Q

What can cause fibrotic stricturing leading to gastric outlet obstruction?

A

Late complication of PUD

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3
Q

What features of the history might be present in gastric outlet obstruction?

A

History of bloating, early satiety, and nausea

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4
Q

How does gastric outlet obstruction present?

A

Copious projectile, non-bilious vomiting a few hours after meals

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5
Q

What might the vomit contain in gastric outlet obstruction?

A

Stale food

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6
Q

What may be found on examination in gastric outlet obstruction?

A

Epigastric distention

Succession splash

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7
Q

How is gastric outlet obstruction investigated?

A

ABG
AXR
OGD
Contrast meal

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8
Q

What is found on ABG in gastric outlet obstruction?

A

Hypochloraemic hypokalaemia metabolic alkalosis

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9
Q

What is found on AXR in gastric outlet obstruction?

A

Dilated gastric air bubble

Collapsed distal bowel

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10
Q

How is metabolic abnormality corrected in gastric outlet obstruction?

A

0.9% normal saline and KCl

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11
Q

How is benign gastric outlet obstruction managed?

A

Endoscopic balloon dilatation

Pyloroplasty or gastroenterostomy

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12
Q

How is malignant gastric outlet obstruction managed?

A

Stenting

Resection

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13
Q

What is the male to female ratio of hypertrophic pyloric stenosis?

A

M:F = 4:1

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14
Q

Which race has a higher incidence of hypertrophic pyloric stenosis?

A

Caucasians

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15
Q

When does hypertrophic pyloric stenosis present?

A

6-8 weeks old

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16
Q

How does hypertrophic pyloric stenosis present?

A

Projectile vomiting minutes after feeding

17
Q

What is found on examination in hypertrophic pyloric stenosis?

A

RUQ mass size of olive

Visible peristalsis

18
Q

How is hypertrophic pyloric stenosis diagnosed?

A

Test feed to palpate mass and see peristalsis

Ultrasound

19
Q

What is found on ABG in hypertrophic pyloric stenosis?

A

Hypochloraemic hyperkalaemia metabolic acidosis

20
Q

How is hypertrophic pyloric stenosis managed?

A

Resuscitate and correct metabolic abnormality
NGT
Ramstedt pyloromyotomy

21
Q

What happens in a Ramstedt pyloromyotomy?

A

The muscularis propria is divided

ANKI GI (43 decks)

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