A 25-year-old man presented with repeated vomiting of undigested food was admitted to the hospital. The patient underwent upper digestive endoscopy. The scope revealed food and fluid in the stomach. Also, the scope revealed a completely obstructed pyloric ring with disturbed anatomy. Every time, the endoscopist tried to get into the duodenum there is much resistance with redirection of the scope away from the pyloric ring towards the fundus.
You can note that even fluid cannot pass through the
pylorus denoting complete obstruction.
Also, you can observe that despite the pyloric ring looks
opened, it is very difficult for the scope to go through it into the duodenum.
The patient gives a history of obstructive jaundice and
CBD stent due to query malignant lesions.
Surgical bypass showed completely obstructed pylorus, the surgeon tried many times to pass his little finger through the pylorus, but he failed. Also, the surgery revealed a retro-
pancreatic mass with omental Mets. Histopathology
and immunohistochemistry revealed adenocarcinoma of GIT# origin.
Comments