Malignant gastric outlet obstruction: a clinicopathological study in S. C. B. medical college hospital of Odisha, India

Abstract

Background: Gastric outlet obstruction is the clinical and pathophysiological consequence of any disease process that produces a mechanical impediment to gastric emptying. The causes of gastric outlet obstruction can be broadly classified as benign (non-cancerous) or malignant (cancerous). Unless treated in its early stage the prognosis of this disease is very poor. Present study includes details of clinical and pathological aspects of the disease, the treatment protocol and outcomes in the causes of malignant gastric outlet obstruction.Methods: A total number of forty diagnosed case of gastric outlet obstruction due to carcinoma stomach were included in this study who were admitted to the surgical wards. The diagnosis of the disease was established by subjecting them to the physical examination and special diagnostic modalities like, upper GI endoscopy and endoscopic biopsy, USG abdomen, barium meal x ray of the stomach, FNAC, histopathological study of operated specimens.Results: USG examination showed 32 cases out of 40 suggestive of growth in stomach. Barium meal X ray showed 15 patients reported persistent filling defect. Occult blood was 87 % positive. FNAC results showed 91% having epigastric clump and 9 % Virchow node. At laparotomy 75% growth was polyploidal, 20%extravacative and 5% of lienitis plastica.10 cases of early gastric carcinoma were subjected to curative resections. Patients who presented multiple metastasis were subjected to gastrojejunal anastomosis. 12 clinicopathological and surgical factors were considered for analysis.Conclusions: Clinicopathological and surgical factors have definite bearing in prognosticating (predicting) the outcome of surgery in carcinoma of stomach.