Chung Yip  Chan,Tan Hiang  Jin,
A rare case of spontaneously resolved gastric outlet obstruction
Surgical Case Reports
2019
2613-5965
http://dx.doi.org/10.31487/j.SCR.2019.01.013
https://www.sciencerepository.org/a-rare-case-of-spontaneously-resolved-gastric-outlet-obstruction_SR-SCR-2019-1-113 
Abstract: Purpose: Gastric outlet obstruction (GOO) rarely occurs after surgery. Even rarer, in cases of living donor
liver transplantation (LDLT). Adhesive bands causing obstruction can be managed conservatively, failing
so, will require surgical intervention. We describe a rare case of GOO due to adhesion band that resolved
spontaneously after more than a month of conservative management.
Method: A 71-year-old gentleman undergone living donor liver transplantation (LDLT) in our institution.
2 months post-operatively, he developed gastric outlet obstruction. Water soluble contrast meal performed
revealed hold up of contrast in first and second portion of duodenum (D1/D2) likely due to adhesions.
Results: He was started on total parenteral nutrition (TPN) to build up his nutritional status and planned
for gastric-jejunal (GJ) bypass as his symptoms did not resolve after a week. However, one month later,
his condition improved drastically, and he was able to tolerate diet. A repeat water-soluble contrast meal
showed a complete resolution of GOO more than 1 month after clinical presentation.
Conclusion: In the event gastric outlet obstruction in a malnourished patient, conservative treatment with
TPN and ‘drip and suck’ may be beneficial and can lead to spontaneous resolution without surgery
required.Keywords: Gastric outlet obstruction, Spontaneous, Resolved