In “Three glass test” shreds are present in 1stglass only. The likely diagnosis would be:
**Core Concept**
The three glass test is a diagnostic tool used to differentiate between partial and complete gastric outlet obstruction. The presence of food particles in the first glass suggests that the obstruction is located beyond the pylorus.
**Why the Correct Answer is Right**
In a complete gastric outlet obstruction, the pyloric sphincter is obstructed, preventing the normal passage of food into the duodenum. This results in the accumulation of food particles in the stomach, which are then regurgitated into the esophagus, often with a characteristic "shred" appearance. The presence of shreds in the first glass is indicative of a complete gastric outlet obstruction.
**Why Each Wrong Option is Incorrect**
* **Option A:** Gastric volvulus would present with food particles in all three glasses, as the stomach is twisted and food is not able to pass through the pylorus.
* **Option B:** Peptic ulcer disease would not typically present with shreds in the first glass, as the obstruction is usually partial and food is able to pass through the pylorus.
* **Option C:** pyloric stenosis would present with projectile vomiting, but the presence of shreds in the first glass is not a characteristic finding.
**Clinical Pearl / High-Yield Fact**
The three glass test is a simple and effective way to differentiate between partial and complete gastric outlet obstruction, but it is essential to note that the presence of shreds in the first glass is not pathognomonic and other causes should be considered.
**Correct Answer: C. Pyloric stenosis is not the best answer but it is the closest option to pyloric obstruction.**