Case Report
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Feb 14, 2016; 22(6): 2153-2158
Published online Feb 14, 2016. doi: 10.3748/wjg.v22.i6.2153
Acquired double pylorus: Clinical and endoscopic characteristics and four-year follow-up observations
Jing-Jing Lei, Li Zhou, Qi Liu, Chun-Fang Xu
Jing-Jing Lei, Li Zhou, Qi Liu, Department of Gastroenterology, the Affiliated Baiyun Hospital of Guizhou Medical University, Guiyang 550014, Guizhou Province, China
Chun-Fang Xu, Department of Gastroenterology, the First Affiliated Hospital of Soochow University, Suzhou 215006, Jiangsu Province, China
Author contributions: Lei JJ designed and drafted the manuscript; Xu CF made critical revisions related to important intellectual content in the manuscript; Zhou L and Liu Q collected and analyzed the patient’s clinical data.
Institutional review board statement: The study was reviewed and approved by the Institutional Review Board of the Affiliated Baiyun Hospital of Guizhou Medical University.
Informed consent statement: All study participants provided informed written consent prior to study enrolment.
Conflict-of-interest statement: All authors declare that they have no conflicting interests (such as commercial, personal, political, intellectual or religious or other equity interest) with regard to the subject matter or materials discussed in this manuscript.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Chun-Fang Xu, Professor, Department of Gastroenterology, the First Affiliated Hospital of Soochow University, 188 Shizi Street, Suzhou 215006, Jiangsu Province, China. xcf601@163.com
Telephone: +86-512-67780357 Fax: +86-512-65228072
Received: September 19, 2015
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
Abstract

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.

Keywords: Acquired double pylorus, Peptic ulcer, Gastrointestinal hemorrhage, Nonsteroidal anti-inflammatory drugs, Helicobacter pylori

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.