Double pylorus accompanied by gastric ulcer resistant to H2-receptor antagonist--a case report and review of the literature
Yoshimura, Y.; Yasutake, K.; Imamura, Y.; Oimomi, M.
Kobe Journal of Medical Sciences 34(4): 151-159
1988
ISSN/ISBN: 0023-2513 PMID: 2905754 Document Number: 4003
A 48-year-old female was admitted to our hospital with epigastralgia. Endoscopy revealed an ulcer on the posterior wall of the greater curvature near the pyloric ring and a fistula, distinct from the pyloric ring and adjacent to it. We showed the fistula to connect the antrum and the duodenal bulb by running a cannula through it. We therefore diagnosed this as a double pylorus accompanied by gastric ulcer. We treated the ulcer with an H2 receptor antagonist, but effected no improvement. We therefore administered some prostagladin El derivatives as well, and progress is now under observation. Both congenital and acquired origins have been proposed for the double pylorus; we believe this case to have been acquired. We also review 65 cases of double pylorus from the Japanese literature.
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