1987 Volume 29 Issue 2 Pages 318-327
A case of double pylorus was reported. A 62-year-old male visited our hospital with the complaint of epigastralgia. Upper gastrointestinal fluoroscopic and endoscopic examination revealed double pylorus having a second opening on the lesser curvature with an active duodenal ulcer. An endoscopical film of this patient, taken 10 years ago, showed only deformity of the prepyloric region but not a double pylorus. We considered this case to be an acquired type of double pylorus. Forty-three cases (male 32, female 11) of double pylorus, including this case, are reported in Japan up to 1985. The mean age was 61.4 years and the genesis was considered to be congenital in 2 cases, acquired in 33 cases, and undetermined in 8 cases. The second opening in these cases were located on the lesser curvature side of the pylorus in 33, 6 on the greater curvature and 1 on the anterior wall and 3 cases were not explained clearly. Seventeen cases were treated surgically and 26 cases conservatively. The term of double pylorus includes all abnormalities which have an opening, other than original pylorus, between the gastric antrum and duodenal bulb. We therefore suggest that this acquired type of double pylorus should be called a perppyloric gastroduodenal fistula.
