Helicobacter-pylori gastritis associated with gastric outlet and biliary obstruction

Background and aims: Helicobacter pylori (HP) causes peptic ulcer disease and occasionally gastric outlet obstruction (GOO) but not biliary obstruction. We describe a case of severe HP gastritis causing both GOO and biliary stricture. Methods: Clinic notes, imaging, endoscopy and pathology reports, and hospital course were reviewed. Design: Single case report. Setting: Tertiary care, academic medical center. Participant/s: One patient encountered in clinical practice. The hospital course is described retrospectively. Clinic notes; endoscopy, pathology, and operative reports; imaging studies are discussed. Interventions: CT scan, esophagastroduodenoscopy (EGD), endoscopic ultrasound (EUS), and endoscopic retrograde cholangiopancreatography (ERCP). She received conservative medical treatment. Results: HP gastritis, GOO, and obstructive biliary stricture were diagnosed by EGD and ERCP. Peptic ulcer and malignancy were excluded. Medical therapy was curative and resolution confirmed by repeat EGD/ERCP. Conclusions: HP can cause both GOO and biliary stricture, for which medical therapy may be curative.