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    J Korean Soc Radiol. 2010 Sep;63(3):245-247. Korean.
    Published online Sep 30, 2010.
    https://doi.org/10.3348/jksr.2010.63.3.245
    Copyright © 2010 The Korean Society of Radiology
    Case Report

    Double Pylorus After a Peptic Ulcer in the Gastric Antrum: A Case Report

    Jang-Hyeon Song, M.D., Jin Woong Kim, M.D.,2 Yong Yeon Jeong, M.D.,2 Suk Hee Heo, M.D.,2 Sang Soo Shin, M.D., Heoung Keun Kang, M.D.,2 and Young Hoe Heo, M.D.3
      • 1Department of Diagnostic Radiology, Chonnam National University Medical School, Chonnam National University Hospital, Gwang-Ju, Korea.
      • 2Department of Diagnostic Radiology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, Jeollanam-do, Korea.
      • 3Department of Hepato-Pancreato-Biliary Surgery, Chonnam National University Medical School, Chonnam National University Hospital, Gwang-Ju, Korea.
    • Address reprint requests to: Jin Woong Kim, M.D., Department of Diagnostic Radiology, Chonnam National University Medical School, Chonnam National University Hwasun Hospital, 160 Ilsim-ri, Hwasun-eup, Hwasun-gun, Jeollanam-do 519-763, Korea. Tel. 82-61-379-7104, Fax. 82-61-379-7133, Email: jw4249@hanmail.net
    Received April 18, 2010; Accepted May 27, 2010.

    Abstract

    Double pylorus is an accessory channel between the gastric antrum and duodenal bulb with a normal pyloric canal. It is understood that the etiology of double pylorus is a congenital anomaly or an acquired complication after the occurrence of peptic ulcer disease. We report the CT findings with CT gastrography of double pylorus as a complication after a previous peptic ulcer in the gastric antrum.

    Keywords
    Pylorus; Computed tomography (CT); Gastric fistula

    Figures

    Fig. 1
    Fig. 1. Double pylorus as a complication after previous peptic ulcer in the gastric antrum in a 54-year-old man.
    A. Endoscopic image shows the peptic ulcer (white arrowhead) in the lesser curvature of gastric antrum and the pyloric canal (arrow).

    B. 2D axial CT image shows a normal pylorus (arrow) and abnormal channel (arrowhead) between gastric antrum and duodenal bulb.

    C. CT gastrogram shows double orifices of a normal pylorus (arrow) and abnormal channel (arrowhead) in the gastric antrum.

    D. After 4 months, follow up endoscopic image shows the upper abnormal channel (black arrowhead) between the gastric antrum and duodenal bulb at the same site of a peptic ulcer on previous endoscopic image, and the lower true pyloric canal (arrow).

    E. Image of upper gastrointestinal series (after 2 months) shows the upper abnormal channel (arrowhead) in the lesser curvature between gastric antrum and duodenal bulb and the lower true pyloric canal (arrow).

    References

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    MeSH Terms
    Gastric Fistula
    Peptic Ulcer
    Pyloric Antrum
    Pylorus
    Metrics
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