Question
The most common metabolic abnormality associated with gastric outlet obstruction is
The correct answer is
hypochloraemic alkalosis
Gastric Outlet Obstruction Explained
Gastric outlet obstruction occurs when there is a blockage at the end of the stomach, preventing food and fluid from passing into the small intestine. This commonly results from conditions like peptic ulcers, tumors, or inflammation.
Mechanism of Metabolic Abnormality
The primary consequence of gastric outlet obstruction is persistent vomiting. The vomitus contains a significant amount of hydrochloric acid (HCl) from the stomach.
- Fluid Loss: Continuous vomiting leads to the loss of gastric fluids rich in HCl.
- Hypochloraemia: The substantial loss of chloride ions (Cl-) via vomiting results in low blood chloride levels, known as hypochloraemia.
- Alkalosis: The loss of HCl makes the blood less acidic. The body attempts to compensate by retaining hydrogen ions (H+) and bicarbonate (HCO3-). Increased bicarbonate levels in the blood lead to a higher pH, causing metabolic alkalosis. Volume depletion from vomiting also stimulates the kidneys to retain sodium and bicarbonate, exacerbating the alkalosis.
Resulting Condition
Therefore, the combination of chloride loss and the body's compensatory mechanisms for acid loss leads to hypochloraemic alkalosis as the most common metabolic abnormality associated with gastric outlet obstruction.
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Important Questions from Stomach
- A 50 year old male patient presents to the emergency with sudden onset of upper abdominal pain, nausea, vomiting and haematemesis. On examination, PR = $106/min$, BP = $100/70$ mm Hg and pallor is present. CECT abdomen reveals a large exophytic tumor of size $13 \times 8$ cm at the fundus of the stomach. On upper GI endoscopy, the mucosa overlying the tumor is intact. The staining for CD117 in the upper GI endoscopic biopsy is positive. The most probable clinical diagnosis in this patient is
- Which of the following statements about peptic ulcers is correct?
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- A gentleman of 36 years presented with a long history of upper abdominal pain which was periodic and often occurred early morning. For last 3 months, he is having projectile vomiting, which is non bilious, unpleasant in nature with undigested food materials. On examination he appears unwell, dehydrated and seemed to have lost weight. Probably he is suffering from:
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