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K31.5 – Gastric Outlet Obstruction (ICD-10)
K31.5 is an ICD-10 diagnosis code for obstruction of the pylorus in adults. It describes a narrowing or blockage of the gastric outlet of non-congenital origin.
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K31.5 is an ICD-10 diagnosis code for obstruction of the pylorus in adults. It describes a narrowing or blockage of the gastric outlet of non-congenital origin.
What Does ICD-10 Code K31.5 Mean?
The ICD-10 code K31.5 stands for obstruction of the pylorus in adults – a narrowing or blockage of the pylorus, which is the muscular valve connecting the stomach to the small intestine (duodenum). When this passage is obstructed, stomach contents cannot empty properly into the small intestine. The code belongs to the ICD-10 group K31 (Other diseases of stomach and duodenum) and is distinct from congenital hypertrophic pyloric stenosis in infants (Q40.0).
Causes
Gastric outlet obstruction in adults can have several underlying causes:
- Peptic ulcer disease: Chronic gastric or duodenal ulcers can cause scarring and fibrosis leading to pyloric stenosis.
- Malignancy: Gastric cancer or pancreatic head tumors can compress or invade the pyloric region.
- Chronic gastritis: Long-standing inflammation can result in fibrotic changes and narrowing.
- Crohn disease: Inflammatory bowel disease can occasionally affect the gastric outlet.
- Post-surgical scarring: Previous abdominal surgery can result in adhesions or scar tissue narrowing the pylorus.
Symptoms
Typical symptoms of gastric outlet obstruction (K31.5) include:
- Vomiting – often of undigested or partially digested food, typically hours after eating
- Epigastric pain – upper abdominal pain, often described as pressure or cramping
- Early satiety – feeling full after only small meals
- Abdominal distension and visible gastric peristalsis
- Weight loss and malnutrition in prolonged cases
- Electrolyte imbalances (e.g., hypokalemia, metabolic alkalosis due to repeated vomiting)
Diagnosis
The following diagnostic methods are used to evaluate suspected K31.5:
- Esophago-gastro-duodenoscopy (EGD / gastroscopy): The gold standard for direct visualization of the pylorus and biopsy in cases of suspected malignancy.
- Barium meal / upper GI series: Evaluates gastric emptying and the degree of obstruction.
- Abdominal ultrasound: Initial imaging to rule out mass lesions.
- CT abdomen: Particularly useful when malignancy is suspected, to assess extent and lymph node involvement.
- Laboratory tests: Electrolytes, renal function, and blood count to identify complications.
Treatment
Treatment depends on the underlying cause of the obstruction:
Conservative Treatment
- Proton pump inhibitors (PPIs) for ulcer-related stenosis
- Eradication of Helicobacter pylori if infection is confirmed
- Parenteral or enteral nutrition to stabilize nutritional status in severely affected patients
Endoscopic Treatment
- Balloon dilation: Endoscopic widening of the narrowing using a balloon catheter – especially effective for benign, scarring-related stenosis.
- Stent placement: Insertion of a self-expanding metal stent, commonly used for palliative management of malignant obstruction.
Surgical Treatment
- Pyloroplasty or gastroenterostomy in refractory cases
- Gastric resection (e.g., distal gastrectomy) when malignancy is confirmed
References
- World Health Organization (WHO): International Statistical Classification of Diseases and Related Health Problems, 10th Revision (ICD-10), Code K31.5.
- Longo DL et al.: Harrison's Principles of Internal Medicine, 21st edition, McGraw-Hill, 2022.
- Chowdhury A et al.: Gastric Outlet Obstruction – Etiology, Diagnosis and Management. Journal of Gastroenterology and Hepatology, 2020.
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