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K31.3 – Pyloric Stenosis in Adults (ICD-10)
K31.3 is an ICD-10 diagnosis code for acquired pyloric stenosis in adults – a narrowing of the gastric outlet that obstructs the passage of stomach contents into the small intestine.
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K31.3 is an ICD-10 diagnosis code for acquired pyloric stenosis in adults – a narrowing of the gastric outlet that obstructs the passage of stomach contents into the small intestine.
What Does ICD-10 Code K31.3 Mean?
The ICD-10 code K31.3 refers to acquired pyloric stenosis in adults (non-congenital). The pylorus is the muscular valve at the lower end of the stomach that controls the passage of partially digested food (chyme) into the duodenum (the first part of the small intestine). When this opening becomes narrowed or obstructed, gastric emptying is impaired, leading to a range of digestive symptoms.
Causes
Unlike congenital pyloric stenosis in infants (ICD-10: Q40.0), acquired pyloric stenosis in adults is typically caused by:
- Peptic ulcer disease: Scarring and fibrosis following recurrent ulcers at or near the pylorus is the most common cause
- Malignancy: Gastric cancer or pancreatic head carcinoma can compress or invade the pylorus
- Chronic inflammation: Conditions such as Crohn's disease with gastric involvement
- Scar tissue formation: Following surgery or ingestion of corrosive substances
- Hypertrophic pyloric muscle: Rarely, primary muscular hypertrophy can occur in adults
Symptoms
Symptoms arise as a result of impaired or blocked gastric emptying and may include:
- Vomiting: Often large volumes of undigested or partially digested food, typically without bile
- Postprandial fullness: Feeling of bloating or heaviness shortly after eating
- Nausea: Persistent, especially after meals
- Weight loss: Due to reduced food intake and impaired nutrient absorption
- Upper abdominal pain or discomfort
- Belching and distension
- Dehydration and electrolyte disturbances: In severe or prolonged cases (e.g., hypochloremic metabolic alkalosis)
Diagnosis
Diagnosis is confirmed through a combination of clinical assessment and investigations:
- Esophagogastroduodenoscopy (EGD): Upper endoscopy is the gold standard – it allows direct visualization of the narrowing and biopsy sampling to exclude malignancy
- Barium meal / upper GI contrast study: Demonstrates delayed gastric emptying and the site of obstruction
- Abdominal ultrasound: Initial non-invasive assessment
- CT of the abdomen: To rule out tumors or external compression
- Gastric emptying scintigraphy: Functional measurement of stomach emptying time
Treatment
Treatment depends on the underlying cause of the stenosis:
Conservative Management
- Nasogastric decompression: To relieve gastric distension and correct fluid and electrolyte imbalances
- Proton pump inhibitors (PPIs): To reduce gastric acid secretion, particularly in ulcer-related stenosis
- Helicobacter pylori eradication: When H. pylori infection is identified as the causative factor
Interventional and Surgical Treatment
- Endoscopic balloon dilation: Minimally invasive widening of the stenosis using a balloon catheter – preferred in benign, scar-related cases
- Surgical pyloroplasty: Surgical widening of the pyloric channel
- Gastrectomy or gastric resection: In cases of malignant obstruction, depending on staging
- Gastrojejunostomy: Surgical bypass procedure for palliative management of inoperable tumors
References
- German Institute for Medical Documentation and Information (DIMDI) / BfArM: ICD-10-GM Version 2024, Code K31.3 – Pyloric stenosis, non-congenital. www.bfarm.de
- Lanas A, Chan FKL: Peptic ulcer disease. Lancet. 2017;390(10094):613-624. doi:10.1016/S0140-6736(16)32404-7
- Sabiston DC, Townsend CM (eds.): Sabiston Textbook of Surgery: The Biological Basis of Modern Surgical Practice. 21st ed. Elsevier, Philadelphia 2022.
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