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Case Report

A Case of Double Pylorus Presenting with Ulcer Bleeding

The Ewha Medical Journal 2012;35(1):54-57. Published online: March 31, 2012

Department of Internal Medicine, Ewha Womans University School of Medicine, Seoul, Korea.

Corresponding author: Ki Nam Shim, Department of Internal Medicine, Ewha Womans University School of Medicine, 1071 Anyangcheon-ro, Yangcheon-gu, Seoul 158-710, Korea. Tel: 82-2-2650-2632, Fax: 82-2-2650-6190, skimkn@ewha.ac.kr
• Received: September 6, 2011   • Accepted: November 21, 2011

Copyright © 2012. Ewha Womans University School of Medicine

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  • Double pylorus is one of the rare anomalies of gastrointestinal tract, which have an accessory canal connecting the distal stomach to the duodenal bulb. The majority of the cases is thought to be acquired lesions from ulcer disease except some congenital cases. We report a case of a 77 year-old male who was visited the hospital because of the melena and diagnosed double pylorus. The relevant literatures on subject were reviewed.
  • 1. Lee JY, Lee HJ, Lee JS, Hyun JN, Kim SM, Kim SY, et al. A case of double pylorus accompanied by duodenal ulcer. Korean J Gastrointest Endosc 2007;35:96-99.
  • 2. Kim HC, Kim SD, Chung TJ, Cho KH, Lee TH, Yoon CM. Double pylorus: a case report. Korean J Gastrointest Endosc 1981;1:45-48.
  • 3. Hu TH, Tai DI, Changchien CS, Chen TY, Chang WC. Double pylorus: report of a longitudinal follow-up in two refractory cases with underlying diseases. Am J Gastroenterol 1995;90:815-818.
  • 4. Kim CJ, Kwon JH, Kim BI, Jun WK, Yoo YS, Park JR, et al. A case of gastroduodenal fistula. Korean J Gastroenterol 1993;25:757-760.
  • 5. Hu TH, Tsai TL, Hsu CC, Lu SN, Hsiao M, Changchien CS. Clinical characteristics of double pylorus. Gastrointest Endosc 2001;54:464-470.
  • 6. Wieczorek RL, Seidman I, Ranson JH, Ruoff M. Congenital duplication of the stomach: Case report and review of the English literature. Am J Gastroenterol 1984;79:597-602.
  • 7. Yoshimura Y, Yasutake K, Imamura Y, Oimomi M. Double pylorus accompanied by gastric ulcer resistant to H2-receptor antagonist-a case report and review of the literature. Kobe J Med Sci 1988;34:151-159.
  • 8. Einhorn RI, Grace ND, Banks PA. The clinical significance and natural history of the double pylorus. Dig Dis Sci 1984;29:213-218.
Fig. 1
Endoscopic finding of 2 years ago. Gastric ulcer is seen at the lesser curvature of antrum.
emj-35-54-g001.jpg
Fig. 2
Endoscopic findings of double pylorus. (A) The huge active ulcer with whitish exudates is noted in pylorus. (B) An accessory channel into the duodenal bulb is confirmed by follow-up endoscopy.
emj-35-54-g002.jpg
Table 1
The clinical features of the cases of double pylorus in the reported Korean literatures

*Ulcer bleeding, hypothyroidism, chronic bronchitis and diabetes.

emj-35-54-i001.jpg
Table 2
The symptoms of the cases of double pylorus in the reported Korean literatures

*Nonspecific symptom: nausea, vomiting and dyspepsia.

emj-35-54-i002.jpg

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      A Case of Double Pylorus Presenting with Ulcer Bleeding
      Image Image
      Fig. 1 Endoscopic finding of 2 years ago. Gastric ulcer is seen at the lesser curvature of antrum.
      Fig. 2 Endoscopic findings of double pylorus. (A) The huge active ulcer with whitish exudates is noted in pylorus. (B) An accessory channel into the duodenal bulb is confirmed by follow-up endoscopy.
      A Case of Double Pylorus Presenting with Ulcer Bleeding

      The clinical features of the cases of double pylorus in the reported Korean literatures

      *Ulcer bleeding, hypothyroidism, chronic bronchitis and diabetes.

      The symptoms of the cases of double pylorus in the reported Korean literatures

      *Nonspecific symptom: nausea, vomiting and dyspepsia.

      Table 1 The clinical features of the cases of double pylorus in the reported Korean literatures

      *Ulcer bleeding, hypothyroidism, chronic bronchitis and diabetes.

      Table 2 The symptoms of the cases of double pylorus in the reported Korean literatures

      *Nonspecific symptom: nausea, vomiting and dyspepsia.

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