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.
