Appropriate management of severe vomiting associated with gastric outlet obstruction from peptic ulcer disease includes all of the following except:

E. Oral antacid therapy.

DISCUSSION: All patients should undergo nasogastric suction, rehydration, and control of acid secretion. This control of acid secretion requires an H 2 antagonist since oral antacids are often inadequate to neutralize the large volume of acid often present in the obstructed stomach. Patients with a long history of obstruction are often nutritionally compromised and need careful nutritional assessment before operative planning.