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Gastric outlet obstruction (GOO) is a medical condition where there is an obstruction at the level of the pylorus, which is the outlet of the stomach. Individuals with gastric outlet obstruction will often have recurrent vomiting of food that has accumulated in the stomach, but which cannot pass into the small intestine due to the obstruction.
Pyloric stenosis is a narrowing of the opening from the stomach to the first part of the small intestine (the pylorus). [1] Symptoms include projectile vomiting without the presence of bile. [1] This most often occurs after the baby is fed. [1] The typical age that symptoms become obvious is two to twelve weeks old. [1]
The most common symptoms of a duodenal ulcer are waking at night with upper abdominal pain, and upper abdominal pain that improves with eating. [1] With a gastric ulcer, the pain may worsen with eating. [7] The pain is often described as a burning or dull ache. [1] Other symptoms include belching, vomiting, weight loss, or poor appetite. [1]
Gastrectomy, gastric bypass surgery, diabetes, esophageal surgery, absent or inefficient pyloric sphincter, pyloric stenosis Dumping syndrome occurs when food, especially sugar, moves too quickly from the stomach to the duodenum —the first part of the small intestine—in the upper gastrointestinal (GI) tract .
Retained gastric material greater than three hours after a meal will generate a splash sound and indicate the presence of a hollow viscus filled with both fluid and gas. An example would be a gastric outlet obstruction (GOO) due to pyloric stenosis, with abdominal succussion splash. [1]
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The pyloric sphincter, surrounding the pyloric orifice is a strong ring of smooth muscle at the end of the pyloric canal which lets food pass from the stomach to the duodenum. It acts as a valve , controlling the outflow of gastric contents into the duodenum [ 6 ] and release of chyme .
Auscultation of the abdomen can produce several clues to the cause of nausea and vomiting. A high-pitched tinkling sound indicates possible bowel obstruction, while a splashing "succussion" sound is more indicative of gastric outlet obstruction. Eliciting pain on the abdominal exam when pressing on the patient may indicate an inflammatory process.