Q:

Which of the following statement(s) is/are correct with regard to pyloric obstruction secondary to peptic ulceration?

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Which of the following statement(s) is/are correct with regard to pyloric obstruction secondary to peptic ulceration?


  1. Pyloric obstruction is suggested by hypochloremic hyponatremic alkalosis
  2. Pyloric obstruction is suggested by hypochloremic hypokalemic alkalosis
  3. Approximately 80% of patients with benign gastric outlet obstruction obtain permanent relief of symptoms by endoscopically-directed balloon dilatation
  4. The lifetime risk of pyloric obstruction in peptic ulcer patients is 40%

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b. Pyloric obstruction is suggested by hypochloremic hypokalemic alkalosis

Repeated episodes of ulceration and healing can lead to scarring and pyloric stenosis. The lifetime risk of this complication approximates 10%. Gastric outlet obstruction is characterized by the development of hypochloremic hypokalemic alkalosis due to loss of HCl through vomiting and renal compensatory mechanisms that conserve H+ at the expense of secreted K+. Although 85% of pyloric stenoses are technically amenable to balloon dilatation, fewer than 1 in 3 will achieve permanent relief of symptoms through this means.

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