A case report of double pylorus: a rare endoscopic finding | ||||
| African Journal of Gastroenterology and Hepatology | ||||
| Volume 8, Issue 1, 2025, Page 1-7 PDF (247.63 K) | ||||
| Document Type: Case Reports | ||||
| DOI: 10.21608/ajgh.2025.331053.1067 | ||||
 View on SCiNiTO | ||||
| Authors | ||||
Zelalem Mulu Lashitie   1; Wudassie Melak Asmare2; Abdulsemed Mohammed Nur3; Mengistu Erkie Minaye3
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| 1Gastroenterology, Internal Medicine, Felege Hiwot Comprehensive Specialized Hospital, Bahirdar, Ethiopia | ||||
| 2Internal medicine, Medical, Bahirdar University, Bahirdar, Ethiopia | ||||
| 3Gastroenterology, Internal Medicine, Addis Ababa University, Addis Ababa, Ethiopia | ||||
| Abstract | ||||
| Introduction Double pylorus or duplication of the pylorus is a rare condition characterized by a gastrointestinal fistula between the gastric antrum and the duodenal bulb. It may be present at birth or developed later. There are few case reports of this condition worldwide. Patients having acquired double pylorus have symptoms related to the underlying cause, such as peptic ulcer disease or other conditions like gastric cancer. In congenital cases, most are asymptomatic. Case presentation We report a case of a 41-year-old female with a history of epigastric burning-type pain for the past 1 week, which was associated with a single episode of hematemesis. She received treatment with intravenous omeprazole for the same period before being referred to our hospital. The physical findings were unremarkable. She was evaluated with endoscopy, during which a double pylorus was incidentally found. She was later treated with 40mg of pantoprazole orally once daily, with subsequent improvement in symptoms. Conclusion Double pylorus is a rare and unexpected endoscopic finding. A typical, two-orifice pylorus is observed during diagnostic endoscopy. Medical management of such patients rests on proton pump inhibitors or histamine receptor blockers. Patients refractory to medical management and those with symptoms of gastric outlet obstruction benefit from interventional endoscopic procedures and surgical management for optimal outcomes. Our patient responded for medical management and is currently under follow-up. | ||||
| Keywords | ||||
| Peptic ulcer disease; gastric polyps; esophagogastroduodenoscopy; double pylorus; penetration; H.pylori | ||||
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