Which physical sign is most indicative of gastric outlet obstruction?

Which physical sign is most indicative of gastric outlet obstruction?

• A. Succussion splash
• B. Grey Turner's sign
• C. Murphy sign
• D. Cullen sign

Answer: (A)

The main idea is that gastric outlet obstruction causes the stomach to become distended with air and fluid. When you gently shake or move the patient and listen over the stomach, the contents can slosh, producing a splash that can be heard with a stethoscope or felt as a wave in the epigastrium. This succussion splash is a classic sign of significant gastric distension from obstruction and points toward gastric outlet obstruction. The other signs reflect different issues: Grey Turner's sign is flank ecchymosis from retroperitoneal hemorrhage or pancreatitis; Cullen sign is periumbilical ecchymosis from intra-abdominal bleeding; Murphy sign is inspiratory arrest and pain in the right upper quadrant indicating acute cholecystitis. These do not indicate gastric outlet obstruction, so the succussion splash is the best indicator in this scenario.

The main idea is that gastric outlet obstruction causes the stomach to become distended with air and fluid. When you gently shake or move the patient and listen over the stomach, the contents can slosh, producing a splash that can be heard with a stethoscope or felt as a wave in the epigastrium. This succussion splash is a classic sign of significant gastric distension from obstruction and points toward gastric outlet obstruction.

The other signs reflect different issues: Grey Turner's sign is flank ecchymosis from retroperitoneal hemorrhage or pancreatitis; Cullen sign is periumbilical ecchymosis from intra-abdominal bleeding; Murphy sign is inspiratory arrest and pain in the right upper quadrant indicating acute cholecystitis. These do not indicate gastric outlet obstruction, so the succussion splash is the best indicator in this scenario.