Differential Diagnosis for Gastric Outlet Obstruction
- Single Most Likely Diagnosis
- Peptic ulcer disease: This is the most common cause of gastric outlet obstruction, particularly duodenal ulcers. The chronic inflammation and scarring from ulcers can lead to narrowing of the gastric outlet.
- Other Likely Diagnoses
- Gastric cancer: Malignancies in the stomach, especially those located near the pylorus, can cause obstruction by either direct invasion or external compression.
- Inflammatory conditions (e.g., Crohn's disease): Chronic inflammation from conditions like Crohn's disease can lead to strictures and narrowing of the gastric outlet.
- Pyloric stenosis: This condition, often seen in infants but can also occur in adults, involves thickening of the pylorus muscle leading to obstruction.
- Do Not Miss Diagnoses
- Gastric volvulus: Although rare, this condition involves the stomach twisting on itself, which can lead to obstruction and potentially severe complications if not promptly addressed.
- External compression (e.g., from pancreatic cancer or pseudocysts): Obstruction caused by external compression from adjacent structures like tumors or pseudocysts can have significant implications for management and prognosis.
- Intussusception: A condition where a part of the intestine telescopes into another, which can cause obstruction and is critical to diagnose due to the risk of ischemia.
- Rare Diagnoses
- Eosinophilic gastroenteritis: A rare condition characterized by eosinophilic infiltration of the gastrointestinal tract, which can lead to obstruction among other symptoms.
- Gastric bezoars: Accumulations of food or other material in the stomach that can cause obstruction, particularly in individuals with altered gastric anatomy or motility disorders.
- Congenital anomalies (e.g., pyloric atresia): Although typically diagnosed in infancy, some congenital anomalies may not become apparent until later in life, leading to gastric outlet obstruction.