gastric outlet obstruction


Summary: The hindering of output from the STOMACH into the SMALL INTESTINE. This obstruction may be of mechanical or functional origin such as EDEMA from PEPTIC ULCER; NEOPLASMS; FOREIGN BODIES; or AGING.

Top Publications

  1. Graham R, Stein P. Gastric outlet obstruction in an infant: lactobezoar. Am J Emerg Med. 2007;25:98-9 pubmed
  2. O KEEFE S, Rolniak S, Raina A, Graham T, Hegazi R, Centa Wagner P. Enteral feeding patients with gastric outlet obstruction. Nutr Clin Pract. 2012;27:76-81 pubmed publisher
    ..In conclusion, NGJ feeding provides a relatively safe conservative management for critically ill patients with upper gastrointestinal obstructions, reducing the need for surgery and parenteral feeding. ..
  3. Albayrak F, Dursun H, Albayrak Y, Altas S, Uyanik A, Yildirim R. Inflammatory myofibroblastic tumor of the stomach in an adult woman: a rare intermittent cause of gastric outlet obstruction. Tumori. 2010;96:492-5 pubmed
    ..Inflammatory myofibroblastic tumor is a neoplasm of intermediate biological potential that frequently recurs and rarely metastasizes...
  4. van Hooft J, Mutignani M, Repici A, Messmann H, Neuhaus H, Fockens P. First data on the palliative treatment of patients with malignant gastric outlet obstruction using the WallFlex enteral stent: a retrospective multicenter study. Endoscopy. 2007;39:434-9 pubmed
    b>Gastric outlet obstruction can occur as a late complication of a variety of cancers. Palliation of the obstructive symptoms is the primary aim of treatment in these patients...
  5. Appasani S, Kochhar S, Nagi B, Gupta V, Kochhar R. Benign gastric outlet obstruction--spectrum and management. Trop Gastroenterol. 2011;32:259-66 pubmed
    ..extrinsic obstruction of the pyloric channel or duodenum either by benign or malignant diseases leads to gastric outlet obstruction. With improvement in science and technology, the spectrum of gastric outlet obstruction has changed from ..
  6. Lowe A, Beckett C, Jowett S, May J, Stephenson S, Scally A, et al. Self-expandable metal stent placement for the palliation of malignant gastroduodenal obstruction: experience in a large, single, UK centre. Clin Radiol. 2007;62:738-44 pubmed
    ..gastroduodenal stenting is a highly favourable treatment for patients with inoperable malignant gastric outlet obstruction. The results suggest that this minimally invasive procedure has a very high technical success rate, ..
  7. Lesurtel M, Dehni N, Tiret E, Parc R, Paye F. Palliative surgery for unresectable pancreatic and periampullary cancer: a reappraisal. J Gastrointest Surg. 2006;10:286-91 pubmed
    ..This strategy remains to be compared to endoscopic palliation in this setting. ..
  8. Pallati P, Puri V, Mittal S. Gastric outlet obstruction secondary to Morgagni hernia: a case report. Hernia. 2008;12:209-12 pubmed
    An 89-year old female presented to us with symptoms of gastric outlet obstruction which appeared to be secondary to gastric volvulus on preoperative work-up...
  9. Larssen L, Medhus A, Hauge T. Treatment of malignant gastric outlet obstruction with stents: an evaluation of the reported variables for clinical outcome. BMC Gastroenterol. 2009;9:45 pubmed publisher
    Malignant gastric outlet obstruction (GOO) is commonly seen in patients with advanced gastric-, pancreatic-, duodenal, hepatobiliary or metastatic malignancies...

More Information


  1. Gemmel C, Weickert U, Eickhoff A, Schilling D, Riemann J. Successful treatment of gallstone ileus (Bouveret's syndrome) by using extracorporal shock wave lithotripsy and argon plasma coagulation. Gastrointest Endosc. 2007;65:173-5 pubmed
  2. Jeurnink S, Steyerberg E, van Hooft J, van Eijck C, Schwartz M, Vleggaar F, et al. Surgical gastrojejunostomy or endoscopic stent placement for the palliation of malignant gastric outlet obstruction (SUSTENT study): a multicenter randomized trial. Gastrointest Endosc. 2010;71:490-9 pubmed publisher
    ..and stent placement are commonly used palliative treatments of obstructive symptoms caused by malignant gastric outlet obstruction (GOO). Compare GJJ and stent placement. Multicenter, randomized trial...
  3. Cappell M, Davis M. Characterization of Bouveret's syndrome: a comprehensive review of 128 cases. Am J Gastroenterol. 2006;101:2139-46 pubmed
    ..of Bouveret's syndrome was missed at esophagogastroduodenoscopy (EGD)--despite endoscopic findings of gastric outlet obstruction caused by a hard, nonfleshy, and convex pyloric mass--prompted this review...
  4. Kim J, Song H, Shin J, Hu H, Lee S, Jung H, et al. Metallic stent placement in the palliative treatment of malignant gastric outlet obstructions: primary gastric carcinoma versus pancreatic carcinoma. AJR Am J Roentgenol. 2009;193:241-7 pubmed publisher
    ..of our study was to compare the clinical effectiveness of metallic stent placement for relief of gastric outlet obstruction caused by gastric carcinoma and pancreatic carcinoma...
  5. Guzman E, Dagis A, Bening L, Pigazzi A. Laparoscopic gastrojejunostomy in patients with obstruction of the gastric outlet secondary to advanced malignancies. Am Surg. 2009;75:129-32 pubmed
    Surgical palliation is an important therapeutic goal in patients with gastric outlet obstruction from cancer. The use of laparoscopic approaches for this condition has not been well studied...
  6. Sharma K, Ranka P, Goyal P, Dabi D. Gastric outlet obstruction in children: an overview with report of Jodhpur disease and Sharma's classification. J Pediatr Surg. 2008;43:1891-7 pubmed publisher
    b>Gastric outlet obstruction (GOO) is overwhelmingly described as infantile hypertrophic pyloric stenosis that overshadows other causes; thereby, there is a need to develop an elaborate and comprehensive classification...
  7. Jeurnink S, van Eijck C, Steyerberg E, Kuipers E, Siersema P. Stent versus gastrojejunostomy for the palliation of gastric outlet obstruction: a systematic review. BMC Gastroenterol. 2007;7:18 pubmed
    Gastrojejunostomy (GJJ) is the most commonly used palliative treatment modality for malignant gastric outlet obstruction. Recently, stent placement has been introduced as an alternative treatment...
  8. Al Rashedy M, Dadibhai M, Shareif A, Khandelwal M, Ballester P, Abid G, et al. Laparoscopic gastric bypass for gastric outlet obstruction is associated with smoother, faster recovery and shorter hospital stay compared with open surgery. J Hepatobiliary Pancreat Surg. 2005;12:474-8 pubmed
    Laparoscopic gastric bypass for relief of gastric outlet obstruction (GOO) is feasible and safe. However, comparative data to confirm the benefits of the laparoscopic approach remain scarce...
  9. Song G, Kang D, Kim T, Heo J, Kim G, Cho M, et al. Endoscopic stenting in patients with recurrent malignant obstruction after gastric surgery: uncovered versus simultaneously deployed uncovered and covered (double) self-expandable metal stents. Gastrointest Endosc. 2007;65:782-7 pubmed
    Uncovered, rather than covered, metal stents are commonly used for palliation of malignant gastric outlet obstruction because of the low risk of stent migration, but tumor ingrowth risk is a major drawback...
  10. Gaidos J, Draganov P. Treatment of malignant gastric outlet obstruction with endoscopically placed self-expandable metal stents. World J Gastroenterol. 2009;15:4365-71 pubmed
  11. Kim J, Song H, Shin J, Choi E, Kim T, Jung H, et al. Metallic stent placement in the palliative treatment of malignant gastroduodenal obstructions: prospective evaluation of results and factors influencing outcome in 213 patients. Gastrointest Endosc. 2007;66:256-64 pubmed
    ..Chemotherapy after stent placement, albeit associated with increased migration rates, is associated with an increase in the maintenance of stent patency. ..
  12. Bakker J, Haber M, Garcia F. Gastrointestinal neurofibromatosis: an unusual cause of gastric outlet obstruction. Am Surg. 2005;71:100-5 pubmed
    ..We report the first case of gastric outlet obstruction with perforation caused by neurofibroma in a patient with NF-1...
  13. Park S, Mok Y, Kim J, Park S, Kim S, Kim C. Clinical significance of gastric outlet obstruction on the oncologic and surgical outcomes of radical surgery for carcinoma of the distal stomach. J Surg Oncol. 2009;100:215-21 pubmed publisher
    To determine the significance of gastric outlet obstruction (GOO) on the outcomes of radical surgery for distal gastric cancer...
  14. Maetani I, Isayama H, Mizumoto Y. Palliation in patients with malignant gastric outlet obstruction with a newly designed enteral stent: a multicenter study. Gastrointest Endosc. 2007;66:355-60 pubmed
    ..To evaluate clinical experience with a new woven enteral stent in the treatment of gastric outlet obstruction. From January 2005 to August 2006, patients with unresectable malignant gastric outlet obstruction were ..
  15. Mehta S, Hindmarsh A, Cheong E, Cockburn J, Saada J, Tighe R, et al. Prospective randomized trial of laparoscopic gastrojejunostomy versus duodenal stenting for malignant gastric outflow obstruction. Surg Endosc. 2006;20:239-42 pubmed
    ..01). There was no change following LGJ. Duodenal stenting is a safe means of palliating malignant gastric outflow obstruction. It offers significant advantages for patients compared with minimal-access surgery. ..
  16. Lin C, Tung C, Peng Y, Chow W, Chang C, Hu W. Successful treatment with a combination of endoscopic injection and irrigation with coca cola for gastric bezoar-induced gastric outlet obstruction. J Chin Med Assoc. 2008;71:49-52 pubmed publisher
    We report a case of gastric bezoar-induced gastric outlet obstruction that was successfully treated with a combination of endoscopic injection and irrigation with Coca Cola...
  17. Kim T, Kang D, Kim G, Heo J, Song G, Cho M, et al. Self-expandable metallic stents for palliation of patients with malignant gastric outlet obstruction caused by stomach cancer. World J Gastroenterol. 2007;13:916-20 pubmed
    ..A retrospective review was performed throughout August 2000 to June 2005 of 53 patients with gastric outlet obstruction caused by stomach cancer...
  18. Fancellu A, Niolu P, Scanu A, Feo C, Ginesu G, Barmina M. A rare variant of gallstone ileus: Bouveret's syndrome. J Gastrointest Surg. 2010;14:753-5 pubmed publisher
    Bouveret's syndrome (gastric outlet obstruction due to impaction of a stone) is a rare variant of gallstone ileus...
  19. Mohammed A, Benmousa A, Almeghaiseeb I, Alkarawi M. Gastric outlet obstruction. Hepatogastroenterology. 2007;54:2415-20 pubmed
    To study causes of gastric outlet obstruction (GOO) in Saudi patients in a tertiary hospital. During one year (between March 2005 and April 2006), twelve patients were referred to the gastroenterology department as possible GOO...
  20. Koulaouzidis A, Moschos J. Bouveret's syndrome. Narrative review. Ann Hepatol. 2007;6:89-91 pubmed
    ..It has high success rate, with acceptable surgical morbidity and mortality. Heightened awareness of this syndrome may lead to decreased morbidity and mortality. ..
  21. Kiely J, Dua K, Graewin S, Nakeeb A, Erickson B, Ritch P, et al. Palliative stenting for late malignant gastric outlet obstruction. J Gastrointest Surg. 2007;11:107-13 pubmed
    Malignant gastric outlet obstruction (MGO) is a late complication of pancreatobiliary and gastric cancers...
  22. Hoover K, Piotrowski J, St Pierre K, Katz A, Goldstein A. Simultaneous gastric and small intestinal trichobezoars--a hairy problem. J Pediatr Surg. 2006;41:1495-7 pubmed
    ..This case emphasizes the role of radiographic imaging in the diagnosis of trichobezoars and the importance of a complete clinical evaluation of the small bowel at the time of removal of an obstructing gastric bezoar...
  23. Farooq F, Wong R, Yang P, Post A. Gastric outlet obstruction as a complication of argon plasma coagulation for watermelon stomach. Gastrointest Endosc. 2007;65:1090-2 pubmed
  24. El Faleh I, Lutz N, Osterheld M, Reinberg O, Nydegger A. Gastric outlet obstruction by Brunner's gland hyperplasia in an 8-year-old child. J Pediatr Surg. 2009;44:E21-4 pubmed publisher
    ..We report the third and youngest case of gastric outlet obstruction because of Brunner's gland hyperplasia focusing on histopathologic condition and treatment based on a ..
  25. Cherian P, Cherian S, Singh P. Long-term follow-up of patients with gastric outlet obstruction related to peptic ulcer disease treated with endoscopic balloon dilatation and drug therapy. Gastrointest Endosc. 2007;66:491-7 pubmed
    Previous studies suggest that endoscopic balloon dilatation (BD) in gastric outlet obstruction (GOO) related to peptic ulcer disease (PUD) does not achieve long-term remission and most patients require surgery...
  26. Kazi H, O Reilly D, Satchidanand R, Zeiderman M. Endoscopic stent insertion for the palliation of malignant gastric outlet obstruction. Dig Surg. 2006;23:28-31 pubmed
    ..exists as to whether endoscopic or minimally invasive/open bypass is superior in cases of malignant gastric outlet obstruction. Retrospective observational study following those patients admitted to the hospital between January ..
  27. Jeurnink S, Steyerberg E, Hof G, van Eijck C, Kuipers E, Siersema P. Gastrojejunostomy versus stent placement in patients with malignant gastric outlet obstruction: a comparison in 95 patients. J Surg Oncol. 2007;96:389-96 pubmed
    ..GJJ) and duodenal stent placement are the most commonly used palliative treatment modalities for gastric outlet obstruction (GOO). In this retrospective study, we compared GJJ and stent placement with regard to medical effects...
  28. Rana S, Bhasin D, Chandail V, Gupta R, Nada R, Kang M, et al. Endoscopic balloon dilatation without fluoroscopy for treating gastric outlet obstruction because of benign etiologies. Surg Endosc. 2011;25:1579-84 pubmed publisher
    Benign gastric outlet obstruction (GOO) causes considerable morbidity and conventional treatment has been surgery...
  29. Jensen A, Trankiem C, Lebovitch S, Grewal H. Gastric outlet obstruction secondary to a large trichobezoar. J Pediatr Surg. 2005;40:1364-5 pubmed
  30. Navarra G, Musolino C, Venneri A, De Marco M, Bartolotta M. Palliative antecolic isoperistaltic gastrojejunostomy: a randomized controlled trial comparing open and laparoscopic approaches. Surg Endosc. 2006;20:1831-4 pubmed
    b>Gastric outlet obstruction is a common, often preterminal, event for patients with inoperable neoplasms of the distal stomach, duodenum, and biliopancreatic area. It can be surgically managed by open or laparoscopic gastrojejunostomy...
  31. Ozokutan B, Ceylan H, Ertaskin I, Yapici S. Pediatric gastric outlet obstruction following corrosive ingestion. Pediatr Surg Int. 2010;26:615-8 pubmed publisher
    ..Gastric injury after corrosive ingestion is relatively uncommon as compared with esophageal injury. Gastric outlet obstruction (GOO) is a significant complication of corrosive ingestion.
  32. Maetani I, Ukita T, Tada T, Ikeda M, Seike M, Terada H, et al. Gastric emptying in patients with palliative stenting for malignant gastric outlet obstruction. Hepatogastroenterology. 2008;55:298-302 pubmed
    Palliative stenting for gastric outlet obstruction (GOO) offers a more rapid resumption of oral intake than surgical gastrojejunostomy. Clinically, delayed gastric emptying is observed less frequently in patients with enteral stenting...
  33. Denley S, Moug S, Carter C, McKay C. The outcome of laparoscopic gastrojejunostomy in malignant gastric outlet obstruction. Int J Gastrointest Cancer. 2005;35:165-9 pubmed
    The development of gastric outlet obstruction (GOO) in patients with advanced pancreatic cancer is regarded by some as a terminal event...
  34. Maetani I, Akatsuka S, Ikeda M, Tada T, Ukita T, Nakamura Y, et al. Self-expandable metallic stent placement for palliation in gastric outlet obstructions caused by gastric cancer: a comparison with surgical gastrojejunostomy. J Gastroenterol. 2005;40:932-7 pubmed
    In patients with gastric outlet obstruction (GOO), palliative enteral stenting is a less invasive procedure compared with gastroenterostomy. Most diseases analyzed in previous studies of such stenting were pancreaticobiliary malignancies...
  35. Ly J, O Grady G, Mittal A, Plank L, Windsor J. A systematic review of methods to palliate malignant gastric outlet obstruction. Surg Endosc. 2010;24:290-7 pubmed publisher
    The traditional approach to palliating patients with malignant gastric outlet obstruction (GOO) has been open gastrojejunostomy (OGJ)...
  36. Freeman H. Endoscopic excision of a prolapsing malignant polyp which caused intermittent gastric outlet obstruction. World J Gastroenterol. 2005;11:5245-7 pubmed
    ..showed a large polyp on a stalk, protruding through the pylorus into the duodenum causing intermittent gastric outlet obstruction. While prolapsing gastric antral polyps are usually benign and hyperplastic, inflammatory or ..
  37. Stupart D, Panieri E, Dent D. Gastrojejunostomy for gastric outlet obstruction in patients with gastric carcinoma. S Afr J Surg. 2006;44:52-4 pubmed
    To investigate the utility of gastrojejunostomy for the palliation of gastric outlet obstruction in irresectable or incurable gastric carcinoma...
  38. Stawowy M, Kruse A, Mortensen F, Funch Jensen P. Endoscopic stenting for malignant gastric outlet obstruction. Surg Laparosc Endosc Percutan Tech. 2007;17:5-9 pubmed
    ..The obstruction was localized in the stomach (n=5), gastrojejunostomy (n=3), or the duodenum (n=16). Self-expanding metal stents were delivered endoscopically under fluoroscopic control...
  39. Gan S, Roy Choudhury S, Agrawal S, Kumar H, Pallan A, Super P, et al. More than meets the eye: subtle but important CT findings in Bouveret's syndrome. AJR Am J Roentgenol. 2008;191:182-5 pubmed publisher
    Gallstones are a rare cause of duodenal or gastric outlet obstruction and therefore are not commonly suspected. Rigler's radiographic triad of pneumobilia, bowel obstruction, and an ectopic gallstone is seen in few of these patients...
  40. Kochhar R, Dutta U, Sethy P, Singh G, Sinha S, Nagi B, et al. Endoscopic balloon dilation in caustic-induced chronic gastric outlet obstruction. Gastrointest Endosc. 2009;69:800-5 pubmed publisher
    The standard treatment of caustic-induced gastric outlet obstruction (GOO) is surgery. There are only a few reports in the medical literature on endoscopic balloon dilation (EBD) for caustic-induced GOO...
  41. Espinel J, Sanz O, Vivas S, Jorquera F, Munoz F, Olcoz J, et al. Malignant gastrointestinal obstruction: endoscopic stenting versus surgical palliation. Surg Endosc. 2006;20:1083-7 pubmed
    ..It is less invasive, avoids the morbidity associated with open gastrojejunostomy, and achieves a faster start to oral food and a shorter hospital stay, leading to a higher quality of life. ..
  42. Sakarya A, Erhan M, Aydede H, Kara E, Ozkol M, Ilkgul O, et al. Gallstone ileus presenting as gastric outlet obstruction (Bouveret's syndrome): a case report. Acta Chir Belg. 2006;106:438-40 pubmed
    ..It most frequently occurs in the terminal ileum. Gastric outlet obstruction syndrome due to the impaction of a gallstone in the duodenum passing through a cholecystoduodenal ..
  43. Lee J, Han Y, Kim C, Lee S, Lee S, Yang D. Fluoroscopic-guided covered metallic stent placement for gastric outlet obstruction and post-operative gastroenterostomy anastomotic stricture. Clin Radiol. 2001;56:560-7 pubmed
    ..covered metallic stent placements in providing palliative care for patients with inoperable malignant gastric outlet obstruction. Under fluoroscopic guidance, placement of self-expandable, covered stents was attempted in 20 patients ..
  44. Yoo B, Lee K, Hahm K, Cho S, Park J, Kim S, et al. Self-expanding coil stent with a long delivery system for palliation of unresectable malignant gastric outlet obstruction: a prospective study. Endoscopy. 2001;33:838-42 pubmed
    ..intubation of a self-expanding metal stent is usually difficult in patients with unresectable malignant gastric outlet obstruction, because the delivery systems currently available are not long enough and cannot easily pass the ..
  45. Charalambous C, Midwinter M, Bancewicz J. Unusual presentation of Bouveret's syndrome. J Gastroenterol. 2002;37:476-8 pubmed
    ..We report what we believe to be the first case of a gallstone causing gastric outlet obstruction while eroding into the duodenum, yet once in the duodenum, passing into the small bowel, causing ileal ..
  46. OlaOlorun D, Oladiran I. Gastric outlet obstruction in Ogbomoso, Nigeria. West Afr J Med. 2001;20:234-7 pubmed
    Forty-three patients were operated upon for gastric outlet obstruction over an eight year period. Six (14%) of these patients bad malignant gastric outlet obstruction...
  47. Born M, Willinek W, Hassan C. [Gastric outlet obstruction in chronic granulomatous disease]. Z Gastroenterol. 2002;40:511-6 pubmed
    ..of chronic granulomatous disease, which led by an inflammatory thickening of the gastric wall to a gastric outlet obstruction. Treatment with prednisone and gamma interferon normalised the thickness of the gastric wall and gastric ..
  48. Pinto Pabón I, Diaz L, Ruiz de Adana J, López Herrero J. Gastric and duodenal stents: follow-up and complications. Cardiovasc Intervent Radiol. 2001;24:147-53 pubmed
    ..Certain technical aspects, e.g., adaptation of stents to bowel morphology, is critical to proper stent function and avoidance of complications. ..
  49. Liew V, Layani L, Speakman D. Bouveret's syndrome in Melbourne. ANZ J Surg. 2002;72:161-3 pubmed
  50. Malvaux P, Degolla R, de Saint Hubert M, Farchakh E, Hauters P. Laparoscopic treatment of a gastric outlet obstruction caused by a gallstone (Bouveret's syndrome). Surg Endosc. 2002;16:1108-9 pubmed
    ..In this way, laparoscopically assisted intraluminal gastric surgery with transpyloric extraction of the stone can be a safe and interesting approach for this type of pathology. ..
  51. Vance P, de Lange E, Shaffer H, Schirmer B. Gastric outlet obstruction following surgery for morbid obesity: efficacy of fluoroscopically guided balloon dilation. Radiology. 2002;222:70-2 pubmed
    To evaluate the efficacy of fluoroscopically guided balloon dilation (FGBD) in patients with symptoms of gastric outlet obstruction following surgery for morbid obesity...
  52. Solt J, Bajor J, Szabo M, Horvath O. Long-term results of balloon catheter dilation for benign gastric outlet stenosis. Endoscopy. 2003;35:490-5 pubmed
    ..Balloon catheter dilation is an important and effective diagnostic and therapeutic method; depending on the causative factor, it can make surgery unnecessary in nearly 70% of patients with benign gastric outlet stenosis. ..
  53. Kim G, Kang D, Lee D, Heo J, Song G, Cho M, et al. Which types of stent, uncovered or covered, should be used in gastric outlet obstructions?. Scand J Gastroenterol. 2004;39:1010-4 pubmed