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Etiological Profile of Mechanical Gastric Outlet Obstruction in Sub-Himalayan Ranges of North India
Brij Sharma1, Neetu Sharma2, Rajesh Kumar1, Rajesh Sharma1, Vishal Bodh1, Amit Sachdeva3
1Department of Gastroenterology, 2Department of Physiology, 3Department of Community Medicine, IGMC, Shimla, H.P, India. 

Corresponding Author
Dr. Vishal Bodh


Background: Gastric outlet obstruction (GOO) is defined as a mechanical impediment to gastric emptying, secondary to complete or partial obstruction of distal stomach, pylorus or proximal duodenum. In contrast to 1970s, when benign diseases were mainly responsible for GOO, malignancy has been the most common cause in recent decades. But there is little data regarding any change over last decade in etiological spectrum of GOO. We therefore conducted this study to find out current trends in etiological spectrum of GOO in India especially in our region.
Methods: A retrospective review of the records of GOO cases from January 2016 to December 2021 was done. Patients in whom a senior gastroenterologist was unable to negotiate the standard gastroscope across pylorus into distal duodenum due to mechanical impediment were considered to have GOO. The data analyzed included age, gender, endoscopic findings and histopathology reports. 
Results: Total 421 patients were included with mean age of 56.9±14.1 years. Three hundred twelve of the 421 (74.1%) patients were male, with male to female ratio of 2.8:1.0. Etiology of GOO was malignant in 53% while benign in 47%. Gastric malignancy was most common cause of malignant GOO while duodenal ulcer was most common cause of benign GOO. 
Conclusion: The etiology of GOO in Himachal Pradesh, Northern India is predominantly malignant (53%) but significant percentages (47%) also have benign causes. Overall gastric malignancy (42.8%) was the most common followed by peptic ulcer disease (42.6%). Males were more commonly affected with GOO than females.