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Chung, Shim, Kwon, Na, Yun, Song, and Kang: A Case of Double Pylorus Presenting with Ulcer Bleeding
Case Report
The Ewha Medical Journal

The Ewha Medical Journal 2012; 35(1): 54-57.

Published online: 31 March 2012

DOI: https://doi.org/10.12771/emj.2012.35.1.54

A Case of Double Pylorus Presenting with Ulcer Bleeding

Jung Wha Chung, Ki Nam Shim, Kyung Joo Kwon, Sun Kyung Na, Hye Won Yun, Do Kyung Song, Suk Hyung Kang

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 6 September 2011       Accepted 21 November 2011

Copyright © 2012. Ewha Womans University School of Medicine

Abstract

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.

Keywords: Double pylorus, Gastric ulcer, Ulcer bleeding

Figures and Tables

Fig. 1
Endoscopic finding of 2 years ago. Gastric ulcer is seen at the lesser curvature of antrum.
emj-35-54-g001
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
Table 1
The clinical features of the cases of double pylorus in the reported Korean literatures
emj-35-54-i001

*Ulcer bleeding, hypothyroidism, chronic bronchitis and diabetes.

Table 2
The symptoms of the cases of double pylorus in the reported Korean literatures
emj-35-54-i002

*Nonspecific symptom: nausea, vomiting and dyspepsia.

References

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.
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