Clinical characteristics of double pylorus

A rare endoscopic finding: acquired double pylorus

“…In our case, the presenting symptom was gastrointestinal bleeding from the gastric ulcers, a condition rarely reported in the literature [7,8]. A long history of treatment with drugs including corticosteroids and nonsteroidal anti-inflammatory drugs (NSAIDs) may also prohibit healing, contributing to fistula formation [2]. Our patient's previous medication included salicylic acid.…”

“…It can be either congenital or acquired. In most cases, it is a complication of peptic ulcer resulting from intramural penetration of the ulcer [2].…”

“…Double pylorus is a rare anomaly found in less than 0.4% of upper endoscopies [1,2]. It is seen twice as often in males when compared with females [2].…”

“…It is seen twice as often in males when compared with females [2]. Frequently, it is a complication of peptic ulcer disease, resulting from penetration of the peptic ulcer and the creation of a fistula between the duodenal bulb and the prepyloric antrum.…”

“…In general, surgical intervention is not a choice of treatment [6], although it should be considered for patients with refractory symptoms, recurrent ulcers, and other complications, even in those taking strong anti-ulcer medication [5]. Spontaneous fusion of both ducts (real pylorus and pseudopylorus) only occurs in a small percentage of patients [2]. Endoscopic treatment is also feasible using a biliary sphincterotomy [5].…”