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The commonest cause of gastric outlet obstruction (GOO) is pyloric stenosis secondary to peptic ulcer disease or gastric carcinoma. Patients with GOO have unique metabolic sequelae, namely hypochloraemic, hypokalaemic metabolic alkalosis with paradoxical aciduria and hypocalcaemia. A case of a patient presenting as GOO is discussed. The aim of this report is to highlight the metabolic abnormalities and management in patients with GOO.

A reminder of the classical biochemical sequelae of adult gastric outlet obstruction