MALIGNANCY IS THE MOST COMMON-CAUSE OF GASTRIC OUTLET OBSTRUCTION EVEN IN A DEVELOPING-COUNTRY

Background and Study Aims: It has recently been reported that in devel oped countries gastric outlet obstruction now predicts gastric maligna ncy. The aim of this study was to find out if this is the case in a de veloping country like India. Patients and Methods: Seventy-four patien ts with gastric outlet obstruction underwent upper gastrointestinal en doscopy 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 ou tlet obstruction was malignant, On clinical and endoscopic appearance three patients were wrongly diagnosed as having malignancy when the ca use, on endoscopic biopsy, was benign (tuberculosis n = 2, and immunop roliferative small intestinal disease n = 1). Twelve of the 18 patient s with benign gastric outlet obstruction were managed conservatively w ith drugs and endoscopic balloon dilatation, Conclusion: Even in a dev eloping country like India, malignancy is the commonest cause of gastr ic outlet obstruction and endoscopic biopsy specimens should be obtain ed in all patients with gastric outlet obstruction because the occasio nal benign lesions can be managed conservatively.