Differential diagnosis of pediatric gastric outlet obstruction

Approach to the differential diagnosis of gastric outlet obstruction:

  • Hypertrophic pyloric stenosis with a thickened pyloric muscle is easily diagnosed on ultrasound and easily distinguished from Prostaglandin E induced gastritis which has thickened pyloric mucosa
  • Bezoar can be suspected on an AXR and confirmed with a careful history
  • Gastroparesis should be suspected in people with long-standing symptoms
  • Gastrostomy tube balloon should be investigated as the cause of gastric outlet obstruction in a patient with a gastrostomy tube
  • Gastroesophageal reflux leading to aspiration is a complication to be concerned about in patients with gastric outlet obstruction