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Gastric Outlet Obstruction due to Gastrointestinal Amyloidosis

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Abstract

A 64- year-old man with smoldering myeloma presented to the hospital for nausea, vomiting, and PO intolerance. Abdominal CT demonstrated massive gastric distention and collapsed proximal duodenum consistent with gastric outlet obstruction (GOO). Esophagogastroduodenoscopy demonstrated pyloric edema. Duodenal biopsies were consistent with AL amyloidosis. Given the concerns for bleeding risk and immediate need to start chemotherapy, surgery was deferred. Chemotherapy was initiated with a good clinical response. Our non-operative approach is novel, eliminates perioperative adverse events, allows for early initiation of chemotherapy, and can serve as a model for patients with GOO resulting from AL amyloidosis who are not surgical candidates.

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Authors’ Contributions

All authors listed above have participated sufficiently as follows:

–Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work,

–Drafting the work or revising it critically for important intellectual content,

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–Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved.

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Authors and Affiliations

  1. Department of Internal Medicine, San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam Houston, TX, 78234, USA

    Jared A. Cohen MD

  2. Department of Hematology and Oncology, San Antonio Military Medical Center, Fort Sam Houston, TX, USA

    Jong An MD & Alexander W. Brown MD

  3. Department of Gastroenterology, San Antonio Military Medical Center, Fort Sam Houston, TX, USA

    Darren Spearman MD & Angelo Paredes MD

Authors
  1. Jared A. Cohen MD
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  2. Jong An MD
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  3. Alexander W. Brown MD
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  4. Darren Spearman MD
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  5. Angelo Paredes MD
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Corresponding author

Correspondence to Jared A. Cohen MD.

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The authors declare that they have no conflicts of interest.

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Informed consent was obtained from the patient for publication of case details. All personal identifying information has been removed to protect personal privacy.

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Cohen, J.A., An, J., Brown, A.W. et al. Gastric Outlet Obstruction due to Gastrointestinal Amyloidosis. J Gastrointest Surg 21, 600–601 (2017). https://doi.org/10.1007/s11605-016-3248-2

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  • DOI: https://doi.org/10.1007/s11605-016-3248-2

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