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[Uncommon condition of the upper gastrointestinal tract: double pylorus]

G Wurm1, T Saers, M Weber

  • 1Kliniken der Stadt Köln gGmbH und Lehrstuhl Innere Medizin II der Universität Witten/Herdecke, Köln, Germany. wurmg@kliniken-koeln.de

Zeitschrift Fur Gastroenterologie
|February 7, 2009
PubMed

Insights

Double pylorus, a rare condition, can be acquired due to peptic ulcers forming a gastroduodenal fistula. This case highlights a duodenal-antral fistula mimicking this rare anomaly in an elderly patient.

Area of Science:

  • Gastroenterology
  • Surgical Pathology

Background:

  • Double pylorus and gastroduodenal fistulas are uncommon congenital or acquired conditions.
  • Acquired forms often result from penetrating peptic ulcers creating a fistula between the duodenal bulb and prepyloric antrum.

Observation:

  • This report details an 85-year-old male patient presenting with symptoms suggestive of a double pylorus.
  • The patient was diagnosed with an acquired duodenal-antral fistula.

Findings:

  • The fistula resulted from retrograde penetration of an ulcer in the duodenum (ulcus duodeni).
  • This condition mimicked the anatomical appearance of a double pylorus on diagnostic evaluation.

Implications:

  • Diagnosis is typically achieved through endoscopy.
  • Surgical intervention is reserved for cases with refractory symptoms, recurrent ulcers, or other complications.

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