Gastric outlet obstruction (GOO) indicates obstruction of the distal stomach, pylorus, or proximal duodenum. The term is also used to encompass lesions in the second through fourth portion of the duodenum as the demarcation between gastric outlet obstruction and duodenal obstruction is inconsistent [1]. GOO can be the result of benign or malignant conditions. While classically GOO was ascribed to noncancerous pathology, a frequently cited review by Johnson et al. of 261 patients with GOO indicated that the epidemiology of GOO is changing [2]. They noted that between 1962 and 1975, malignancy accounted for 33 % of GOO cases at their hospital in the United Kingdom. Between 1976 and 1985 malignancy accounted for 50 % of cases. However, from 1987 to 1988 malignancy was responsible for 66 % of cases of GOO. Current thinking is that GOO in adults is secondary to malignancy unless proven otherwise.