{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T20:47:48Z","timestamp":1782506868023,"version":"3.54.5"},"reference-count":20,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T00:00:00Z","timestamp":1782432000000},"content-version":"vor","delay-in-days":26,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,5,31]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Pseudomyxoma peritonei (PMP) is a rare malignancy characterized by mucinous ascites. Gastric outlet obstruction (GOO) due to extrinsic compression is exceptionally uncommon. We present a 76-year-old male with high-grade appendiceal mucinous neoplasm presented with progressive abdominal pain, nausea, and vomiting. Imaging demonstrated extensive peritoneal disease causing pyloroduodenal compression. Five sequential self-expanding metal stents were placed, providing only transient relief due to persistent compression and tumour overgrowth. With worsening nutritional status, a multidisciplinary team pursued a palliative approach. An endoscopic gastrojejunostomy was performed alongside total parenteral nutrition and nasogastric decompression, resulting in sustained symptom relief and improved quality of life. PMP-related GOO poses significant management challenges. Endoscopic stenting may be ineffective in diffuse mucinous disease. Early consideration of bypass procedures, such as gastrojejunostomy, combined with multidisciplinary care and nutritional optimization, is essential for durable palliation.<\/jats:p>","DOI":"10.1093\/jscr\/rjag516","type":"journal-article","created":{"date-parts":[[2026,6,8]],"date-time":"2026-06-08T11:19:33Z","timestamp":1780917573000},"source":"Crossref","is-referenced-by-count":0,"title":["Pseudomyxoma peritonei presenting with pyloric obstruction: a case report"],"prefix":"10.1093","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1006-9824","authenticated-orcid":false,"given":"Eyad","family":"Jamileh","sequence":"first","affiliation":[{"name":"School of Medicine, Queens University Belfast , 97 Lisburn Road Belfast , BT9 7BL,","place":["United Kingdom"]},{"name":"Department of Gastroenterology, Royal Blackburn Teaching Hospital, Haslingden Road, East Lancashire Hospitals Trust , Blackburn , BB2 3HH,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zuha","family":"Akhtar","sequence":"additional","affiliation":[{"name":"School of Medicine, University of Oxford, Wellington Square, Oxford , Oxfordshire , OX1 2JD,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Babu","sequence":"additional","affiliation":[{"name":"Department of Medicine, Royal Preston Hospital, Sharoe Green Lane, Lancashire Teaching Hospitals NHS Foundation Trust , Preston , PR2 9HT,","place":["United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,26]]},"reference":[{"key":"2026062616092254400_ref1","doi-asserted-by":"publisher","first-page":"329","DOI":"10.14735\/amko2019329","article-title":"Pseudomyxoma peritonei","volume":"32","author":"Barto\u0161ka","year":"2019","journal-title":"Klin Onkol"},{"key":"2026062616092254400_ref2","doi-asserted-by":"publisher","first-page":"252","DOI":"10.1245\/s10434-020-08655-8","article-title":"Estimating the prevalence of pseudomyxoma peritonei in Europe using a novel statistical method","volume":"28","author":"Patrick-Brown","year":"2021","journal-title":"Ann Surg Oncol"},{"key":"2026062616092254400_ref3","doi-asserted-by":"publisher","first-page":"221","DOI":"10.14694\/EdBook_AM.2013.33.221","article-title":"Pathologic diagnosis, origin, and natural history of pseudomyxoma peritonei","volume":"33","author":"Buell-Gutbrod","year":"2013","journal-title":"Am Soc Clin Oncol Educ Book"},{"key":"2026062616092254400_ref4","doi-asserted-by":"publisher","first-page":"335","DOI":"10.1007\/s10555-023-10088-0","article-title":"The genetic profile and molecular subtypes of human pseudomyxoma peritonei and appendiceal mucinous neoplasms: a systematic review","volume":"42","author":"Murage","year":"2023","journal-title":"Cancer Metastasis Rev"},{"key":"2026062616092254400_ref5","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2020-046819"},{"key":"2026062616092254400_ref6","doi-asserted-by":"publisher","first-page":"258","DOI":"10.1007\/s13193-016-0516-2","article-title":"Pathology of mucinous appendiceal tumors and pseudomyxoma peritonei","volume":"7","author":"Ramaswamy","year":"2016","journal-title":"Indian J Surg Oncol"},{"key":"2026062616092254400_ref7","doi-asserted-by":"publisher","first-page":"345","DOI":"10.3949\/ccjm.86a.18035","article-title":"Gastric outlet obstruction: a red flag, potentially manageable","volume":"86","author":"Koop","year":"2019","journal-title":"Cleve Clin J Med"},{"key":"2026062616092254400_ref8","doi-asserted-by":"publisher","first-page":"e8","DOI":"10.1016\/j.amjms.2024.03.005","article-title":"Pyloric stenosis due to advanced gastric cancer in an adult: case report","volume":"368","author":"Yamada","year":"2024","journal-title":"Am J Med Sci"},{"key":"2026062616092254400_ref9","doi-asserted-by":"publisher","first-page":"1446","DOI":"10.3390\/cancers16081446","article-title":"Ovarian causes of pseudomyxoma peritonei \u2013 a literature review","volume":"16","author":"Ionescu","year":"2024","journal-title":"Cancers (Basel)"},{"key":"2026062616092254400_ref10","doi-asserted-by":"publisher","first-page":"845","DOI":"10.1634\/theoncologist.2014-0106","article-title":"FOLFOX-4 chemotherapy for patients with unresectable or relapsed peritoneal pseudomyxoma","volume":"19","author":"Pietrantonio","year":"2014","journal-title":"Oncologist"},{"key":"2026062616092254400_ref11","doi-asserted-by":"publisher","first-page":"78","DOI":"10.1186\/s12957-022-02548-8","article-title":"Rare occurrence of pseudomyxoma peritonei syndrome arising from malignant transformation of an ovarian teratoma: a case report","volume":"20","author":"Ponzini","year":"2022","journal-title":"World J Surg Oncol"},{"key":"2026062616092254400_ref12","article-title":"Pseudomyxoma peritonei: diagnostic challenges in a slow-progressing malignancy","volume":"12","author":"Tsoukalas","year":"2024","journal-title":"Clin Case Reports"},{"key":"2026062616092254400_ref13","doi-asserted-by":"publisher","first-page":"511","DOI":"10.1080\/02656736.2017.1310938","article-title":"Pseudomyxoma peritonei: natural history and treatment","volume":"33","author":"Mittal","year":"2017","journal-title":"Int J Hyperthermia"},{"key":"2026062616092254400_ref14","article-title":"Urological implications of pseudomyxoma peritonei: ascites-induced obstructive uropathy","volume":"15","author":"Zhuang","year":"2022","journal-title":"BMJ Case Rep"},{"key":"2026062616092254400_ref15","doi-asserted-by":"publisher","first-page":"1316","DOI":"10.1002\/jso.27842","article-title":"New insights in the management of pseudomyxoma peritonei","volume":"130","author":"Cl\u00e9ment-Pastier","year":"2024","journal-title":"Curr Oncol Rep"},{"key":"2026062616092254400_ref16","first-page":"e13","article-title":"Malignant gastric outlet obstruction: revisiting endoscopic stenting versus surgical bypass","volume":"55","author":"Askar","year":"2024","journal-title":"J Gastrointest Oncol"},{"key":"2026062616092254400_ref17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1155\/2024\/8137209","article-title":"Quality of life of pseudomyxoma peritonei patients: a scoping review","volume":"2024","author":"Taher","year":"2024","journal-title":"J Patient Rep Outcomes"},{"key":"2026062616092254400_ref18","doi-asserted-by":"publisher","first-page":"8505","DOI":"10.3748\/wjg.v20.i26.8505","article-title":"Gastroenteric tube feeding: techniques, problems and solutions","volume":"20","author":"Blumenstein","year":"2014","journal-title":"World J Gastroenterol"},{"key":"2026062616092254400_ref19","doi-asserted-by":"publisher","first-page":"1326","DOI":"10.3390\/cancers15041326","article-title":"Prognostic factors in pseudomyxoma peritonei: the predictive role of PCI and tumor markers","volume":"15","author":"Blaj","year":"2023","journal-title":"Cancers (Basel)"},{"key":"2026062616092254400_ref20","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1245\/s10434-012-2579-9","article-title":"Quality of life in patients after cytoreductive surgery and HIPEC: is it worth the risk?","volume":"20","author":"Tsilimparis","year":"2013","journal-title":"Ann Surg Oncol"}],"container-title":["Journal of Surgical Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/6\/rjag516\/68629910\/rjag516.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/jscr\/article-pdf\/2026\/6\/rjag516\/68629910\/rjag516.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T20:09:30Z","timestamp":1782504570000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/jscr\/article\/doi\/10.1093\/jscr\/rjag516\/8719255"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5,31]]},"references-count":20,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2026,5,31]]}},"URL":"https:\/\/doi.org\/10.1093\/jscr\/rjag516","relation":{},"ISSN":["2042-8812"],"issn-type":[{"value":"2042-8812","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2026,6]]},"published":{"date-parts":[[2026,5,31]]},"article-number":"rjag516"}}