astric Outlet Obs truction Gastric Decompress

most common (auses:- why do rt?

) GastricCancer oat Indicahons- bdoc

) PyloricStenosis 2'o pephculeration
herca4ses otG00:-
) AdultPyloricstenosis
) Ryloricmucosaldiaphragm
Clhnical feature s:
- lntractable naysea /emesis (whefer caused
by medicahons), īhtoxicat ion
in order to preent aspiraton
Decompression protects pt against
branchial aspiration ot gashic contents
To redue the inner pressure of GIT
3 OMlowing forEndoscopyÎhvestigafhons

Din some pt pain maybecome unremiing.

Physical €xamination
while In some pt, lavgely disappear • Possible to see distended stomah
2)yomihus characteristics:- •SucCUSsioh splash may be qudibie
a) unpleasant in hature on shaling tte ptient's abdomn
b) lack bile
)Possible torecognisefodstut utri onal Spport
taken several days preriouy Parenteral nutrition
d) Postprandial vomiting internal/
central vein:ubclavianeJMgular
etrhal
vtin
in the early stages of obstrucion,
S Peiphra vein : shert term feeding
VO mīting may be ntermient h
usually Occur witthìn lhour of meal
p to 2 weels

Benign Cayses of G0o present wih: Borrmann Classif cation of

)early sai ety uD, NSAID,
H-Pl0ri,
Polyps, Atranced qastric Cancer
)Bloatihg Ghastit TB

nalighant cause of Goo presenis with:

) pain pistal gastric cancer TypeI
)vomiihg • canters at Polypoid
Cquse G00
-Pyloro balbar area
) weight loss - Antrapylone Žone
4) malhutihon - Descendng duodenm Type ll
icial 4lcerahon
• prozimal dvadenum supericial excavain9
45 ampulla (ause bleed pain

metabolic effects:
• Hypochloraemic - caused by vomiting TYpe
allalosis HC)
ulcerati ve
Renortexcreted bicarbnate lcause bleed bpain
• Hypo hatraemic - sodium in utih&

. uie becomeparadoxiCally aidic h 1ype iv

Hypokalaemia ensues. Diffuse thickening
Hkalos is leads to lo"eing in circulating Causeearly qhety
onised (al Cium, and tetahy can OCCUT. Stomach(anhdt la niis plasticq

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 4astric Calcinoma ,48 Mo,HTN,Ayslipidaemia
cc : malaeng I day iar to atnissi on
|·what disease can ause epg9shric
Paln for 2 Months Blaclis h stool ix,not fresh blood,
• chronic pepic ulcer disease semi -solid stool, no soB, no dizzy,
no Feeing cold, sthey foul sneting,very blak
• Gastic Caringma
ho feneshus, no ron supplement
•erosive geshi s
I weel : epigashic pain, dull, no radiahon
• chtonic panreahts
relieved by gastifs rediatien
Diabehc gastoparesis 4ggravated by frod

2. Vomiing of blood Hx of epigastic pain | mnths,

no scope done. no vamiti hg, ho hanateress
* Color:
-Coftee ground vomíhus ho hunger pain, night pain, no dyfpepria

(brawn and gtanular,atered blood tA Early satiety | math ag0

gastic aid - dgested,bleedingfrom 9gaanbly
Peptic ulcer, gastitis Jerosion or variceal siq-heartbum, Sourtaste,
ho dyspepSiM
bleedthathasentr
stsmach) t hypzusalivakon,diff ualoning
-Fresh blood LOA, LOW 88-B6 Lg
(yariceal bleeding, mallo ry Weiss tear, AVM
Cmodenate to severe) NO ted mat,smdhed food
AOnset: no bnge alcohol drining/ Fam Hx :64strie (4
excessi ve vomiting (TRO MW tear)

4. Anemia Symptoms
*Frequenyi Gymptomahc anemia (mportant to ase)
*Qyanhy iCup/baw t o SOB upon exerhon
• Dizzihess
* Tiger| hraftemeal o Syhco pe
(ike asoiaion with ood nake)
• chest paìn
I dftuentiate wthhaemophysis
blood frsm larynx, trachea, brehchih lungs • Palpitation
usually aļwcough,frothy, bight red . lethargy lfaFgue
S. Gonstihtional Sym pto ms
3- Meleng
* Snell : rul snlling, shly,handboftush •Early sathiety
t color: •L0A, Low
Fresh melenq : atmost liquid )a • metastah symptoms
o con51stency lung (S0B,kemoptysis ,chri cngh)
b S49Gestfairly acutebleeding
stale pelendimx ed with hsrmal sfoo|
[v ljaundice,Inr
máss,
Suogest bleed which stopped
Brne(bonepaih,lump aer brhe)
followed with nelera Bratn (heodche, vomifng, kwealats)
ohset *Frequencytcompaetoprevep
* hy receht iran ||axaive taken

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