surgical procedures and management

Apr 15th, 2015
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Gastric Outlet Obstruction(GOO)Dr. George MugenyaMBCHB, M.MED, FCS (ECSA)GOO:DefinitionIt is the clinical and pathophysiologicalconsequence of any disease processthat produces a mechanical impedimentto gastric emptying.It is also known as pyloric obstruction.It can be classified as:AcuteChronicPyloric StenosisAnatomic changes associated with pyloric stenosis.GOO:EpidemiologyIncidence of GOO is not known precisely.It has declined in recent years because of the declinein peptic ulcer disease which had been an importantcause of GOO.Need for surgery for GOO has also declined due to: Decline in incidence of GOO. Advancements in endoscopic methods to treatGOO (such as dilation and stenting).GOO:EtiologyThe term GOO is a misnomer since many cases arenot due to isolated gastric pathology but ratherinvolve duodenal or extraluminal disease.The predominant causes have changed with theidentification of Helicobacter pylori and the use ofproton pump inhibitors.Until the late 1970s, benign disease was responsiblefor the majority of cases of GOO in adults, whilemalignancy accounted for only 10 to 40 % of cases.By contrast, in recent decades, 50 to 80 % of caseshave been attributable to malignancy.GOO: PathophysiologyIntrinsic or extrinsic obstruction of the pyloric channel orduodenum is the usual pathology in GOO.Patients present with intermi

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