Etiopathology of Gastric Outlet Obstruction: A Study in a Tertiary Care Hospital of Bangladesh

Background: Gastric outlet obstruction denotes complete or partial obstruction of the distal stomach, pylorus, or proximal duodenum. This can happen as a result of an obstructing lesion, external compression, or obstruction caused by acute edema, chronic scarring and fibrosis, or a combination of the two. The most common causes of gastric outlet obstruction are gastric cancer and pyloric stenosis secondary to peptic ulceration. Objective: This study aimed to determine the etiopathology of gastric outlet obstruction in patients who presented with its clinical symptoms. Methods: Between September 2012 to February 2013, this prospective observational study was conducted in the Surgery Department of Rangpur Medical College Hospital, Rangpur, Bangladesh. In total 50 patients presenting with the features of gastric outlet obstruction were included in this study as the study subjects. A convenient purposive sampling technique was used in sample selection. Registration schedules, editing computerization, preparing dummy tables, analyzing and matching data were all part of the data processing work. Results were calculated by standard statistical formulae. Results: In this study, the mean ±SD age of the participants was 46±13.71 years. Histopathology reports of all the 22 cases of antral growth revealed adenocarcinoma. We found 4 adenocarcinoma and 4 benign ulcers from the endoscopic biopsy of 8 gastric ulcer cases. Biopsy from 3 pyloric channel ulcers revealed benign lesion and 1 duodenal stricture revealed chronic granulomatous lesion suggestive of tuberculosis. We found 29 (58%) patients of malignant cases of gastric outlet obstruction and 21 (42%) patients of benign cases of gastric outlet obstruction. The mean difference was statistically significant (P<0.05) between benign and malignant group. Conclusion: Among the patients of gastric outlet obstruction, now malignant cases are found more frequently than benign cases. Endoscopic biopsy and histopathology may be considered as the most effective tool for assessing the etiopathology of gastric outlet obstruction.