Change of Clinical Patterns and Significance of Endoscopy in Gastric Outlet Obstruction

Ham, Jeong Ho; Lee, Seok Ho; Kim, Eun Joo; Chung, Il Kwun; Kim, Hong Soo; Park, Sang Heum; Lee, Moon Ho; Kim, Sun Joo

Abstract

BACKGROUND/AIMS: The causes of gastric outlet obstruction (GOO) have changed from peptic ulcer disease (PUD) to malignant diseases in recent years. The aims of this study are to determine the relative incidence of malignany and other causative diseases, and to consider therapeutic and diagnostic usefulness of endoscopy.
METHODS
95 patients with GOO who diagnosed by radiologic and endoscopic examination or surgery were reviewed by causative diseases, clinical features, endoscopic findings and outcome of treatment.
RESULTS
1) The mean age was 57.5 years (M:F=2.4:1). 2) The causative diseases were gastric or duodenal malignancy (56.8%), complication of PUD (39.2%), and biliary and pancreatic disease (4.2%). 3) Malignancy was diagnosed by upper gastrointestinal (UGI) endoscopy in 95.8%; obstruction by complication of PUD was detected by endoscopy in 100%. 4) The most common endoscopic type of malignancy was Borrman type 3 (84.8%) and the most common benign lesions were duodenal or pyloric ulcer (94.5%). 5) The managements of malignancy were operation (53.5%), endoscopic stenting (18.5%), and conservative treatment (38.8%). The complications of PUD were treated by anti-ulcer medication (85.3%), endoscopic dilatation (4.8%) and operation (13.6%).
CONCLUSIONS
The main causes of GOO are changed to malignancy in recent 5 years. Endoscopy is useful to detect the various causes of GOO, and necessary procedure to decide the method of their management.