Evolution of Double Pylorus: Report of a Case

Double pylorus is a gastrointestinal abnormality in which a second channel connects the antrum of stomach to the duodenal bulb, and appears to be an acquired lesion in the majority of cases reported. Herein, we present a case of double pylorus. The patient was a 58-year-old male who was admitted with complaints of tarry stool passage. Panendoscopic study disclosed a protruding mass with an A2 ulcer at prepyloric antrum and submucosal tumor had to be ruled out initially. Tissue biopsy showed merely chronic gastritis. The next follow-up panendoscopy after one-month treatment with H2-blocker simply revealed superficial gastritis. By the 4th to 8th endoscopy during the following four years, a second hole in lesser curvature side of antrum was persistently found. We present this case of evolving double pylorus with a series of panendoscopic studies and barium meal study of UGI series.