Pyloric stenosis complicating duodenal ulceration

Pyloric stenosis would be better termed gastric outlet obstruction but popular usage favors the former title. The most common cause in adults is a stenosing chronic duodenal ulcer, but differential diagnosis must be made clinically, radiologically, and endoscopically from other causes, particularly carcinoma of the gastric antrum. Metabolic disturbances due to fluid and electrolyte loss are not common but, if present, require correction by intravenous replacement therapy. The condition is becoming less common due to the overall decline in incidence of duodenal ulcer in the Western world and the more effective medical treatment of duodenal ulcer with H2antagonists. It is still common, however, in many parts of the Third World. Treatment is invariably surgical but medical preoperative preparation is required. Vagotomy combined with drainage gives excellent results.