S P Misra1, M Dwivedi, V Misra. 1. Dept. of Gastroenterology, M. L. N. Medical College, Allahabad, India. manisha@allahabad@dartmail.dartnet.com
Abstract
BACKGROUND AND STUDY AIMS: It has recently been reported that in developed countries gastric outlet obstruction now predicts gastric malignancy. The aim of this study was to find out if this is the case in a developing country like India. PATIENTS AND METHODS: Seventy-four patients with gastric outlet obstruction underwent upper gastrointestinal endoscopy and biopsy specimens were obtained from any suspicious looking lesions or from the most distal point at which the endoscope could be positioned. RESULTS: In 56 patients (76%) the cause of the gastric outlet obstruction was malignant. On clinical and endoscopic appearance three patients were wrongly diagnosed as having malignancy when the cause, on endoscopic biopsy, was benign (tuberculosis n = 2, and immunoproliferative small intestinal disease n = 1). Twelve of the 18 patients with benign gastric outlet obstruction were managed conservatively with drugs and endoscopic balloon dilatation. CONCLUSION: Even in a developing country like India, malignancy is the commonest cause of gastric outlet obstruction and endoscopic biopsy specimens should be obtained in all patients with gastric outlet obstruction because the occasional benign lesions can be managed conservatively.
BACKGROUND AND STUDY AIMS: It has recently been reported that in developed countries gastric outlet obstruction now predicts gastric malignancy. The aim of this study was to find out if this is the case in a developing country like India. PATIENTS AND METHODS: Seventy-four patients with gastric outlet obstruction underwent upper gastrointestinal endoscopy and biopsy specimens were obtained from any suspicious looking lesions or from the most distal point at which the endoscope could be positioned. RESULTS: In 56 patients (76%) the cause of the gastric outlet obstruction was malignant. On clinical and endoscopic appearance three patients were wrongly diagnosed as having malignancy when the cause, on endoscopic biopsy, was benign (tuberculosis n = 2, and immunoproliferative small intestinal disease n = 1). Twelve of the 18 patients with benign gastric outlet obstruction were managed conservatively with drugs and endoscopic balloon dilatation. CONCLUSION: Even in a developing country like India, malignancy is the commonest cause of gastric outlet obstruction and endoscopic biopsy specimens should be obtained in all patients with gastric outlet obstruction because the occasional benign lesions can be managed conservatively.