Pyloroduodenal Fistula or Acquired Double Pylorus
Whereas a double pylorus had previously been presumed to be of congenital origin, Hansen et al. (1972) described two cases in which the clinical and endoscopic findings indicated that it was usually an acquired lesion. The first patient was a 55-year-old male with a known prepyloric gastric ulcer. Follow-up gastros-copy showed that the ulcer had perforated into the duodenum, forming a short fistulous communication between the stomach and duodenum, which had the appearance of a second pyloric aperture. In the second patient a known duodenal ulcer had perforated through the pyloric ring into the stomach, with a similar result. In both cases a mucosal septum was situated between the two apertures.
KeywordsDuodenal Bulb Truncal Vagotomy Curvature Side Pyloric Ring Epigastric Tenderness
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