Gastric Outlet Obstruction Management
Gastric Outlet Obstruction Management: Suspected GOO → Initial Management → Diagnostic Workup → Etiology → Benign Causes.
Interactive Decision Tree
Algorithm Steps
- ▶Start
Suspected GOO
Non-bilious vomiting, early satiety, distension
- ●Action
Initial Management
NPO, NG decompression, IV fluids
- Correct metabolic alkalosis
- PPI therapy
- Nutrition assessment
- ●Action
Diagnostic Workup
CT, EGD with biopsies
- CT abdomen with contrast
- EGD with multiple biopsies
- UGI series if needed
- ◆Decision
Etiology
- Benign (PUD, caustic, Crohn's)
- Malignant (gastric, pancreatic)
- ●Action
Benign Causes
PUD, caustic, post-surgical
- ●Action
Endoscopic Dilation
Serial balloon dilation
- 15-20mm target
- 70-80% success for PUD
- ■End
Follow-up Care
Nutrition support, surveillance
- ●Action
Surgical - Benign
Pyloroplasty or GJ
- Laparoscopic gastrojejunostomy
- Antrectomy if refractory
- ●Action
Malignant Causes
Gastric, pancreatic, duodenal CA
- ●Action
Resectable
Oncologic resection
- Staging workup first
- Neoadjuvant if indicated
- ●Action
Palliation
Stent or bypass
- SEMS for short life expectancy
- Surgical GJ if stent not feasible
Guideline Source
SAGES Guidelines for Gastric Outlet Obstruction
Clinical Safety Information
Clinical Decision Support — Not a Substitute for Clinical Judgment
Individual patient factors may require deviation from these recommendations.
Known Limitations
- Distinguishing benign from malignant requires adequate tissue sampling
- Stent migration and obstruction are common complications
- Nutritional optimization critical before any intervention
Applicable Regions
UK: AUGIS upper GI surgery guidelines
US: SAGES guidelines standard
Next steps
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Related Resources
Frequently Asked Questions
What is the Gastric Outlet Obstruction Management?
The Gastric Outlet Obstruction Management is a management clinical algorithm for Upper GI Surgery. It provides a structured decision tree to guide clinical decision-making, based on SAGES Guidelines for Gastric Outlet Obstruction.
What guideline is the Gastric Outlet Obstruction Management based on?
This algorithm is based on SAGES Guidelines for Gastric Outlet Obstruction (DOI: 10.1007/s00464-020-07472-2).
What are the limitations of the Gastric Outlet Obstruction Management?
Known limitations include: Distinguishing benign from malignant requires adequate tissue sampling; Stent migration and obstruction are common complications; Nutritional optimization critical before any intervention. Individual patient factors may require deviation from these recommendations.
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