Differential diagnosis of pediatric gastric outlet obstruction

• Hypertrophic pyloric stenosis
• Prostaglandin E induced gastritis
• Bezoar
• Gastrostomy tube balloon causing gastric outlet obstruction
• Mesenteroaxial gastric volvulus
• Organoaxial gastric volvulus
• Gastroparesis

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