title: Double pylorus: a complication of chronic gastric ulcer?
abstract: A case of double pylorus with a chronic ulcer in one of the two channels is described. The patient, a middle-aged man with active rheumatoid arthritis, required partial gastrectomy to allow continued treatment of the arthritis with anti-inflammatory drugs. Detailed histological examination of the surgical specimen revealed features consistent with intramural penetration of an ulcer across the pyloric ring, resulting in a gastro-duodenal fistula. The findings provide further support for the hypothesis that the double pylorus is an acquired lesion, which occurs as an uncommon complication of chronic peptic ulcer.
mesh_terms: D002908:Chronic Disease; D004378:Duodenal Diseases / Q000209:etiology*; D005747:Gastric Fistula / Q000209:etiology*; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D011708:Pylorus; D013276:Stomach Ulcer / Q000150:complications*