Double pylorus formed after gastroduodenal ulcer: three cases report

Double pylorus (DP) means rare morphological abnormalities that form a secondary route other than the pylorus by congenital or acquired factors. We report three cases of DP after gastroduodenal ulcer. Case 1: A 75-year-old man presented with lightheadedness and tarry stool. Emergency endoscopy revealed a gastroduodenal fistula at the antrum other than the pylorus. Case 2: A 56-year-old man presented with epigastralgia. Emergency endoscopy was performed, and a gastroduodenal fistula was found in the pylorus at 0 o'clock. The biopsy results revealed duodenal adenocarcinoma, and surgery was performed. Case 3: An 86-year-old woman presented with nausea. Endoscopy was performed and incidentally DP was detected. DPs (case 1, 3) are based on benign ulcers, and DP (Case 2) is accompanied with malignancy. Since some cases of DP are associated with malignancy, careful endoscopic observation and follow-up are essential.