Bowel sound may be increased (borborygmi) due to excessive peristaltic action of the stomach. Fullness in the left hypochondrium may also be present. Causes
The causes are divided into benign or malignant. Benign
Peptic ulcer disease
Infections, such as tuberculosis; and infiltrative diseases, such as amyloidosis. A rare cause of gastric outlet obstruction is blockage with a gallstone, also termed "Bouveret syndrome" or "Bouverets syndrome". In children congenital pyloric stenosis / congenital hypertrophic pyloric stenosis may be a cause. A pancreatic pseudocyst can cause gastric compression. Pyloric mucosal diaphragm could be a rare cause. Malignant
Tumours of the stomach, including adenocarcinoma (and its linitis plastica variant), lymphoma, and gastrointestinal stromal tumours

Pathophysiology
In a peptic ulcer it is believed to be a result of edema and scarring of the ulcer, followed by healing and fibrosis, which leads to obstruction of the gastroduodenal junction (usually an ulcer in the first part of the duodenum). Diagnosis
The most confirmatory investigation is endoscopy of upper gastrointestinal tract. Laboratory often find hypochloremic, hypokalemic, and alkalotic due to loss of hydrogen chloride and potassium. High urea and creatinine levels may also be observed if the patient is dehydrated. Abdominal X-ray may show a gastric fluid level which would support the diagnosis. Barium meal and follow through may show an enlarged stomach and pyloroduodenal stenosis.Gastroscopy may help with cause and can be used therapeutically. Differential diagnosis
The differential diagnosis of gastric outlet obstruction may include: early gastric carcinoma, hiatal hernia, gastroesophageal reflux, adrenal insufficiency, and inborn errors of metabolism.
Polyhydramnios is a medical condition describing an excess of amniotic fluid in the amniotic sac. It is seen in about 1% of pregnancies. It is typically diagnosed when the amniotic fluid index (AFI) is greater than 24 cm. There are two clinical varieties of polyhydramnios: chronic polyhydramnios where excess amniotic fluid accumulates gradually, and acute polyhydramnios where excess amniotic fluid collects rapidly. The opposite to polyhydramnios is oligohydramnios, not enough amniotic fluid. Presentation
Associated conditions
Fetuses with polyhydramnios are at risk for a number of other problems including cord prolapse, placental abruption, premature birth and perinatal death. At delivery the baby should be checked for congenital abnormalities. Causes
In most cases, the exact cause cannot be identified. A single case may have one or more causes, including intrauterine infection (TORCH), rh-isoimmunisation, or chorioangioma of the placenta. In a multiple gestation pregnancy, the cause of polyhydramnios usually is twin-to-twin transfusion syndrome. Maternal causes include cardiac problems, kidney problems, and maternal diabetes mellitus, which causes fetal hyperglycemia and resulting polyuria (fetal urine is a major source of amniotic fluid). A recent study distinguishes between mild and severe polyhydramnios and showed that Apgar score of less than 7, perinatal death and structural malformations only occurred in women with severe polyhydramnios. In another study, all patients with polyhydramnios, that had a sonographically normal fetus, showed no chromosomal anomalies. (M/C for polyhydramnio is fetal anomalies Williams Obstetrics, 24th Edition – Cunningham,  Leveno, Bloom et al.