Publications

Gastric outlet obstruction (GOO) in adults is caused by pyloric stenosis secondary to peptic ulcer disease or gastric malignancy. We present a rare etiology of invasive colon carcinoma causing GOO in a 28-year-old male. He gave a history of upper abdominal pain for 2 months with nausea, early satiety, vomiting of food particles over 20 days, weight loss of 12 kg, with no other complaints. Examination revealed severe pallor, single enlarged left supraclavicular lymph node, a vague mass palpable in the epigastric region extending into the right hypochondrium, and the presence of succussion splash and ausculto-percussion. Investigations showed hemoglobin of 7.1 g/dl, fecal occult blood test positive, and carcinoembryonic antigen level of 13.92 ng/ml. Esophagogastroduodenoscopy and colonoscopy showed duodenal growth and ascending colon growth, respectively, which was moderately differentiated adenocarcinoma on biopsy. Fine needle aspiration cytology of lymph node showed metastatic adenocarcinoma. Contrast-enhanced computed tomography abdomen clinched the cause as ascending colon mass infiltrating into the 2nd part of duodenum (D2), causing dilatation of stomach and 1st part of duodenum (D1). Mesenteric lymphadenopathy with ascites was also noted