Pyloric Obstruction

Pyloric obstruction, often caused by an underlying organic lesion near the gastric outlet, is a common clinical diagnosis based on its typical history, imaging and endoscopic findings. Patients usually present with progressive nausea, vomiting of residual food, abdominal distension and sometimes abdominal pain. Besides these direct results of pyloric obstruction, prolonged GI disorder often results in reduced intake of food and rapid weight loss. Although extensive diagnostic and therapeutic efforts, mainly various surgical options, have been explored to establish definitive diagnosis and relieve obstruction, less attention is paid to the perioperative nutrition evaluation and support for these patients. It has been demonstrated that improving the nutritional status of these patients will lead to better surgical outcome. While until recently, most hospitals would still directly initiate PN for these patients for ease of setting access route, even though it is more expensive and associated with higher risk of infection and metabolic complications. Choosing between PN and EN has become particularly important when a clear pathological diagnosis is hard to reach and patients require nutritional support for weeks while waiting for a series of gastroscopy to find evidence or exclude the possibility of malignancy. Proper EN support can safely and conveniently improve the nutritional status of these patients while better prepares them for later surgical procedures.

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Last date updated on April, 2024