Double Pylorus Presented with Upper Gastrointestinal Bleeding
Double pylorus,gi bleeding
Abstract
Double pylorus is a rare endoscopic finding, often secondary to chronic peptic ulcer disease and mucosal fistulization. It may become evident incidentally or during an investigation of upper gastrointestinal (GI) bleeding. Our case was a hemodynamically unstable woman who presented with hematemesis. Gastroduodenoscopy revealed a double pylorus with a visible vessel in the bulb region. We successfully controlled the bleeding endoscopically, and the patient was discharged in stable condition. Double pylorus may rarely be observed in patients with recurrent or complicated peptic ulcers. Recognition of this anomaly is essential for appropriate management.
[1] Wetscher G, Schwab G, Glaser K, Fend F, Bodner E, Pointner R. Dieulafoy lesion in a congenital double pylorus. Endoscopy. 1994;26(4):374-5. https://doi.org/10.1055/s-2007-1009003
[2] Wiseman SM, Tan D, Hill HC. Double pylorus: an unusual endoscopic finding. Endoscopy. 2005;37(3):277. https://doi.
org/10.1055/s-2005-86101642 Zare E et al. Double Pylorus Gastrointestinal Bleeding. CRCP. 2025; 10(1):39-42
January/February 2025, Volume 10, Issue 1
[3] Chen QY, Chen Y, Liang, Wang J, Du Q, Cai JT, et al. Acquired double pylorus: a case report. Asian Pac J Trop Med.
2012;5(6):503-4. https://doi.org/10.1016/S1995-7645(12)60087-X
[4] Kothandaraman KR, Kutty KP, Hawken KA, Barrowman JA. Double pylorus--in evolution. J Clin Gastroenterol. 1983;5(4):335-8. https://doi.org/10.1097/00004836-198308000-00010
[5] Hu TH, Tsai TL, Hsu CC, Lu SN, Hsiao M, Changchien CS. Clinical characteristics of double pylorus. Gastrointest
Endosc. 2001;54(4):464-70. https://doi.org/10.1067/mge.2001.117543
[6] Smith VM, Tuttle KW. Gastroduodenal (pyloric) band. Endoscopic findings and the first reported case.
Gastroenterology. 1969;56(2):331-6. https://doi.org/10.1016/S0016-5085(69)80133-2
[7] Christien G, Branthomme JM, Volny L, Deschamps P, Morice A. [Double pylorus: a congenital malformation] Sem Hop. 1971;47(23):1485-8.
[8] Mylonas A, Papaziogas B, Paraskevas G, Fragos E, Gigis P, Papaziogas T. Congenital double pyloric ostium in the adult. Surg Endosc. 2002;16(11):1639. https://doi.org/10.1007/s00464-002-4204-7
[9] Wolters VM, Nikkels PG, Van Der Zee DC, Kramer PP, De Schryver JE, Reijnen IG, et al. A gastric diverticulum
containing pancreatic tissue and presenting as congenital double pylorus: case report and review of the literature. J
Pediatr Gastroenterol Nutr. 2001;33(1):89-91. https://doi.org/10.1002/j.1536-4801.2001.tb07409.x
[10] Sisman G. Concomitant pancreas divisum and double pylorus: a case report. JOP. 2014;15(6):632-4.
[11] Fousekis F, Aggeli P, Kotsaftis P, Pappas-Gogos G. Double Pylorus: Report of a Case With Endoscopic Follow-Up and Review of the Literature. Gastroenterol Res. 2018;11(2):154-6. https://doi.org/10.14740/gr960w
[12] Fattahi MR, Homayoon K, Hamidpour L. Double Pylorus in a Cirrhotic Patient: A Case Report and Review of the Literature. Middle East J Dig Dis. 2012;4(2):130-2.
[13] Atiq O, Abrams G. CASE STUDY IN GASTROENTEROLOGY & HEPATOLOGY: An Uncommon Complication of Peptic Ulcer Disease. Gastroenterol Hepatol (N Y). 2014;10(5):333-4.
[14] Lei JJ, Zhou L, Liu Q, Xu CF. Acquired double pylorus: Clinical and endoscopic characteristics and four-year follow-up observations. World J Gastroenterol. 2016;22(6):2153-8. https://doi.org/10.3748/wjg.v22.i6.2153
[15] Akazawa Y, Mizuta Y, Osabe M, Nakamura T, Morikawa S, Isomoto H, et al. A Case of Double Pylorus Caused by Recurrent Gastric Ulcers: A Long-Term Endoscopic Observation. Dig Dis Sci. 2005;50(11):2125-8. https://doi.org/10.1007/s10620-005-3018-6
[16] Goh BK, Tan HK. Double pylorus. Am J Surg. 2006;191(4):515- 6. https://doi.org/10.1016/j.amjsurg.2005.10.024
[17] Oktaricha H, Miftahussurur M. Double Pylorus in Upper Gastrointestinal Bleeding. Case Rep Gastroenterol.
2021;15(1):332-7. https://doi.org/10.1159/000513804
[18] Peixoto P, Sadio A, Cancela E, Castanheira A, Ministro P, Silva AT, et al. Acute upper bleeding due to an unusual complication of peptic ulcer disease - double pylorus. Rev Esp Enferm Dig.2010;102(7):451-3. https://doi.org/10.4321/S1130-01082010000700012
[2] Wiseman SM, Tan D, Hill HC. Double pylorus: an unusual endoscopic finding. Endoscopy. 2005;37(3):277. https://doi.
org/10.1055/s-2005-86101642 Zare E et al. Double Pylorus Gastrointestinal Bleeding. CRCP. 2025; 10(1):39-42
January/February 2025, Volume 10, Issue 1
[3] Chen QY, Chen Y, Liang, Wang J, Du Q, Cai JT, et al. Acquired double pylorus: a case report. Asian Pac J Trop Med.
2012;5(6):503-4. https://doi.org/10.1016/S1995-7645(12)60087-X
[4] Kothandaraman KR, Kutty KP, Hawken KA, Barrowman JA. Double pylorus--in evolution. J Clin Gastroenterol. 1983;5(4):335-8. https://doi.org/10.1097/00004836-198308000-00010
[5] Hu TH, Tsai TL, Hsu CC, Lu SN, Hsiao M, Changchien CS. Clinical characteristics of double pylorus. Gastrointest
Endosc. 2001;54(4):464-70. https://doi.org/10.1067/mge.2001.117543
[6] Smith VM, Tuttle KW. Gastroduodenal (pyloric) band. Endoscopic findings and the first reported case.
Gastroenterology. 1969;56(2):331-6. https://doi.org/10.1016/S0016-5085(69)80133-2
[7] Christien G, Branthomme JM, Volny L, Deschamps P, Morice A. [Double pylorus: a congenital malformation] Sem Hop. 1971;47(23):1485-8.
[8] Mylonas A, Papaziogas B, Paraskevas G, Fragos E, Gigis P, Papaziogas T. Congenital double pyloric ostium in the adult. Surg Endosc. 2002;16(11):1639. https://doi.org/10.1007/s00464-002-4204-7
[9] Wolters VM, Nikkels PG, Van Der Zee DC, Kramer PP, De Schryver JE, Reijnen IG, et al. A gastric diverticulum
containing pancreatic tissue and presenting as congenital double pylorus: case report and review of the literature. J
Pediatr Gastroenterol Nutr. 2001;33(1):89-91. https://doi.org/10.1002/j.1536-4801.2001.tb07409.x
[10] Sisman G. Concomitant pancreas divisum and double pylorus: a case report. JOP. 2014;15(6):632-4.
[11] Fousekis F, Aggeli P, Kotsaftis P, Pappas-Gogos G. Double Pylorus: Report of a Case With Endoscopic Follow-Up and Review of the Literature. Gastroenterol Res. 2018;11(2):154-6. https://doi.org/10.14740/gr960w
[12] Fattahi MR, Homayoon K, Hamidpour L. Double Pylorus in a Cirrhotic Patient: A Case Report and Review of the Literature. Middle East J Dig Dis. 2012;4(2):130-2.
[13] Atiq O, Abrams G. CASE STUDY IN GASTROENTEROLOGY & HEPATOLOGY: An Uncommon Complication of Peptic Ulcer Disease. Gastroenterol Hepatol (N Y). 2014;10(5):333-4.
[14] Lei JJ, Zhou L, Liu Q, Xu CF. Acquired double pylorus: Clinical and endoscopic characteristics and four-year follow-up observations. World J Gastroenterol. 2016;22(6):2153-8. https://doi.org/10.3748/wjg.v22.i6.2153
[15] Akazawa Y, Mizuta Y, Osabe M, Nakamura T, Morikawa S, Isomoto H, et al. A Case of Double Pylorus Caused by Recurrent Gastric Ulcers: A Long-Term Endoscopic Observation. Dig Dis Sci. 2005;50(11):2125-8. https://doi.org/10.1007/s10620-005-3018-6
[16] Goh BK, Tan HK. Double pylorus. Am J Surg. 2006;191(4):515- 6. https://doi.org/10.1016/j.amjsurg.2005.10.024
[17] Oktaricha H, Miftahussurur M. Double Pylorus in Upper Gastrointestinal Bleeding. Case Rep Gastroenterol.
2021;15(1):332-7. https://doi.org/10.1159/000513804
[18] Peixoto P, Sadio A, Cancela E, Castanheira A, Ministro P, Silva AT, et al. Acute upper bleeding due to an unusual complication of peptic ulcer disease - double pylorus. Rev Esp Enferm Dig.2010;102(7):451-3. https://doi.org/10.4321/S1130-01082010000700012
| Files | ||
| Issue | Vol 10 No 1 (2025): January-February | |
| Section | Case Report(s) | |
| Keywords | ||
| Gastrointestinal bleeding Double pylorus | ||
| Rights and permissions | |
|
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License. |
How to Cite
1.
Zare E, Anvari M, Mortazavi M. Double Pylorus Presented with Upper Gastrointestinal Bleeding. CRCP. 2025;10(1):39-42.
