Abstract

MALDONADO DIA, Mariant  and  DIAZ, Marisela. Double pylorus: an uncommon complication of peptic ulcer disease. A case report. Gen [online]. 2026, vol.80, n.1, pp.57-60.  Epub Feb 01, 2026. ISSN 0016-3503.  https://doi.org/10.61155/gen.v80i1.780.

Double pylorus is a rare, acquired gastrointestinal condition that results from a fistulous tract forming between the gastric antrum and the duodenal bulb, usually due to poor healing of a gastric or duodenal ulcer. Risk factors include poor adherence to antisecretory and/or antiulcer treatments, use of ulcerogenic medications, and preexisting systemic diseases. Clinical case: A 65-year-old female with type 2 diabetes mellitus and chronic NSAID use for lumbar disc disease presented with epigastric pain, gastroesophageal reflux, and a minor episode of wine red hematemesis. Gastroscopy revealed a giant Forrest III ulcer in the gastric antrum. Histology showed multifocal chronic active gastritis due to Helicobacter pylori. Antiulcer, antisecretory, and triple therapy for Helicobacter pylori. were prescribed, but adherence was poor. At 12 weeks, a control gastroscopy demonstrated a gastroduodenal fistula consistent with double pylorus. Discussion: Acquired double pylorus is a rare complication in patients with peptic ulcer disease, especially associated with poor treatment adherence, systemic diseases, and prolonged use of NSAIDs. Conclusion: Peptic ulcer disease can exceptionally progress to gastroduodenal fistula or double pylorus.

Keywords : double pylorus; gastroduodenal fistula; peptic ulcer disease.

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