Published online Feb 14, 2016. doi: 10.3748/wjg.v22.i6.2153
Peer-review started: September 21, 2015
First decision: October 14, 2015
Revised: November 16, 2015
Accepted: December 8, 2015
Article in press: December 8, 2015
Published online: February 14, 2016
Double pylorus (DP), or duplication of the pylorus, is an uncommon condition that can be either congenital or acquired. Acquired DP (ADP) occurs when a peptic ulcer erodes and creates a fistula between the duodenal bulb and the distal stomach. The clinical features and endoscopic characteristics of four patients with ADP were reviewed and compared with previously reported cases. An accessory channel connects the lesser curvature of the prepyloric antrum with the duodenal bulb, and in all cases, a peptic ulcer was located in or immediately adjacent to the accessory channel. In one of the patients, the bridge between the double-channel pylorus disappeared, resulting in a single large opening and duodenal kissing ulcer after two years and three months. Finally, nonsteroidal anti-inflammatory drugs, Helicobacter pylori and other risk factors associated with ADP are assessed.
Core tip: Double pylorus, which can be congenital or acquired, is a relatively rare condition consisting of two openings connecting the antrum to the duodenal bulb. This disease has a prevalence that ranges from 0.001%-0.4% of upper gastrointestinal endoscopies, and only a few reports have documented long-term endoscopic observations for this disease. In this report, we present the clinical and endoscopic characteristics and four years of follow-up observations of four patients with acquired double pylorus complicated with gastric ulcer.