Dr. Siddique Akbar satti has been explaining various causes of gastric outlet obstruction, this case is the continuation of his current subject. This is the case of 76 year old male with past medical history of hypertension and Acid peptic disease presented to the outpatient department of Capital Hospital Islamabad complaining of dyspepsia, early satiety, weight loss since last 3 months and vomiting if he tries to eat more. Lab studies and abdominal ultrasound were unremarkable. All these symptoms in view of his age and previous history of APD suggest that there could be some stricture or growth around gastric outlet, so in order to confirm that Dr. Siddique Akbar Satti went for upper GI endoscopy which was done on 6/4/15. He got the following picture of this old gentle man. Dr. S A Satti writes in his report, “There is a Polypoidal growth in the duodenum bulb causing obstruction in the passage of D2. There is patchy ulceration with muc
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