PMID- 37090344
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20230425
IS  - 2168-8184 (Print)
IS  - 2168-8184 (Electronic)
IS  - 2168-8184 (Linking)
VI  - 15
IP  - 3
DP  - 2023 Mar
TI  - Closed-Loop Gastric Outlet Obstruction Secondary to Duodenal Ulcer in a Patient 
      With Esophageal Stricture.
PG  - e36507
LID - 10.7759/cureus.36507 [doi]
LID - e36507
AB  - Closed-loop gastric outlet obstruction (GOO) is a rare complication that results 
      from a mechanical obstruction in the pylorus or duodenum. In the early 1990s, the 
      common cause of GOO was peptic ulcer disease, accounting for 5% to 10% of 
      hospital admissions. Peptic ulcer disease is the disruption of the mucosal 
      integrity in the stomach and duodenum and can be categorized into gastric ulcers 
      and duodenal ulcers. With the treatment for Helicobacter  pylori and the 
      increased use of proton pump inhibitors (PPI), GOO now occurs in fewer than 5% of 
      patients with duodenal ulcer disease and even less in those with gastric ulcer 
      disease. Although the morbidity of duodenal ulcers has been declining in recent 
      years, the incidence of post-bulbar duodenal ulcer (PBDU) remains at a constant 
      9.33%, primarily due to diagnostic and therapeutic difficulties. Additionally, 
      fewer than 5% of obstructing duodenal ulcers are caused by PBDU, and even fewer 
      are located in the second or third portions of the duodenum. Ulcers located in 
      the distal part of the duodenum raise concern for syndromes associated with 
      hypersecretion of acid, including Zollinger-Ellison syndrome (ZES). The ZES is 
      rare, accounting only for 0.1% of all duodenal ulcers. Here, we present a case 
      where a patient with esophageal stricture developed a rare case of closed-loop 
      GOO secondary to a duodenal ulcer. The patient, initially treated for esophageal 
      perforation, developed an esophageal stricture. The patient was being worked up 
      for ZES and multiple endocrine neoplasia link type 1 (MEN1) syndrome due to his 
      concerning laboratory findings and rare clinical presentation.
CI  - Copyright (c) 2023, Kaur et al.
FAU - Kaur, Jashandeep
AU  - Kaur J
AD  - Medicine, New York Institute of Technology College of Osteopathic Medicine, Old 
      Westbury, USA.
FAU - Stoukides, Georgianna
AU  - Stoukides G
AD  - Medicine, New York Institute of Technology College of Osteopathic Medicine, Old 
      Westbury, USA.
FAU - Amaturo, Michael
AU  - Amaturo M
AD  - General Surgery, Jamaica Hospital Medical Center, New York, USA.
LA  - eng
PT  - Case Reports
DEP - 20230322
PL  - United States
TA  - Cureus
JT  - Cureus
JID - 101596737
PMC - PMC10121273
OTO - NOTNLM
OT  - duodenal ulcer disease
OT  - esophageal stricture
OT  - exploratory laparotomy
OT  - gastric outlet obstruction
OT  - zollinger-ellison syndrome
COIS- The authors have declared that no competing interests exist.
EDAT- 2023/04/24 06:42
MHDA- 2023/04/24 06:43
PMCR- 2023/03/22
CRDT- 2023/04/24 03:40
PHST- 2023/01/12 00:00 [received]
PHST- 2023/03/22 00:00 [accepted]
PHST- 2023/04/24 06:43 [medline]
PHST- 2023/04/24 06:42 [pubmed]
PHST- 2023/04/24 03:40 [entrez]
PHST- 2023/03/22 00:00 [pmc-release]
AID - 10.7759/cureus.36507 [doi]
PST - epublish
SO  - Cureus. 2023 Mar 22;15(3):e36507. doi: 10.7759/cureus.36507. eCollection 2023 
      Mar.