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The Case of the "Double Pylorus"
Ayush Sutaria1, Shamim Ejaz1, Irina M Cazacu1,2
1Department of Gastroenterology, Hepatology and Nutrition, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Current Health Sciences Journal
|July 18, 2025
Summary
A rare "double pylorus" anatomical variation was incidentally discovered during an esophagogastroduodenoscopy (EGD) in a patient treated for esophageal stricture. This finding, a rare congenital anomaly, required no intervention as the patient remained asymptomatic.
Area of Science:
- Gastroenterology
- Anatomical Variations
- Endoscopy
Background:
- A 68-year-old female with a history of small cell lung carcinoma and peptic ulcer disease presented with dysphagia.
- The patient had recently undergone radiation and chemotherapy, which can cause esophageal complications.
Observation:
- Esophagogastroduodenoscopy (EGD) revealed a radiation-induced esophageal stricture.
- Incidently, a rare anatomical variation termed "double pylorus" (DP) was observed.
- This DP finding presented as an additional opening adjacent and superior to the normal pyloric channel.
Findings:
- No evidence of perforation or traumatic injury was associated with the double pylorus.
- Intubation confirmed both openings led into a normal-appearing duodenal bulb.
- The patient was asymptomatic from this anatomical variation.
Implications:
- This case highlights the importance of recognizing incidental anatomical variations during endoscopic procedures.
- Understanding such anomalies is crucial for accurate diagnosis and avoiding misinterpretation of findings.
- The asymptomatic nature of this double pylorus suggests conservative management is appropriate in similar cases.
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