ISSN 2398-2969      

Stomach: gastric outflow disease

icanis

Introduction

  • Causes:
  • Apart from gastric foreign bodies, the most common cause is CHPG in middle-aged small breeds (<l0 kg), eg Dachshund, Cavalier King Charles Spaniel, Lhasa Apso, Shi Tzu.
  • Signs: vomiting.
  • Diagnosis: radiographic demonstration of delayed gastric emptying, gastroscopy with biopsy, expoloratory laparotomy.
  • Treatment: pyloromyotomy Pyloromyotomy , pyloroplasty or pyloric resection. technique selected depends on the type of pyloric disease and age of animal.
  • Prognosis: depends on cause.

Pathogenesis

Etiology

  • Foreign body obstruction.
  • CHPG - benign/paraneoplastic.
  • Congenital pyloric stenosis.
  • Intra- or extraluminal neoplastic disease.

Predisposing factors

General
  • CHPG benign has unknown etiology, but can be associated with increased gastrin with gastrinoma.

Pathophysiology

Pyloric stenosis
  • Brachycephalic breeds.
  • Hypertrophy of gastropyloric smooth muscle.
  • Prevents adequate opening of pylorus.
    Clinical signs only seen once on solid foods.
  • Normally food ground down by pyloric antrum to particle size <2 mm before emptying into duodenum.
  • Maximal pyloric opening 5-6 mm.
  • Inability to open adequately leads to gastric retention and/or delayed gastric emptying.

Timecourse

  • Onset of signs usually at weaning in congenital forms.
  • Progressive onset in adult forms.

Diagnosis

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Treatment

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Outcomes

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Further Reading

Publications

Refereed papers

  • Recent references from PubMed and VetMedResource.
  • Walter M C & Matthiesen D T (1993) Acquired antral​ pyloric hypertrophy in the dog. Vet Clin North Am 23 (3), 547-554 PubMed.
  • Walter M C et al (1985) Chronic hypertrophic pyloric gastropathy as a cause of pyloric obstruction in the dog. JAVMA 186 (2), 157-161 PubMed.

Other sources of information

  • Burrows C F (1996)Gastric disease.In:Manual of canine and feline gastroenterology.D A Thomas, J W Simpson, E J Hall Eds, BSAVA. Cheltenham. pp 90.

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