What question did this study set out to answer?

To present cases of double pylorus and review its literature focusing on acquired cases and management.

June 10, 2026Open Access

Double pylorus: a case report and review of the literature

Key Points

To present cases of double pylorus and review its literature focusing on acquired cases and management.
Presented two case reports: a 72-year-old woman and a 15-year-old girl from Ghana, both treated for peptic ulcer disease.
Endoscopy was used for diagnosis and a biopsy was taken for histopathological examination.
Patients received triple therapy with Metronidazole, Amoxicillin, and Omeprazole for 10 days.
Both patients were diagnosed with gastric ulcers which were confirmed via histopathology with no malignant features.
Helicobacter pylori was detected in both cases, indicating a possible underlying cause of the ulcers.
Both patients reported symptom relief following the triple therapy treatment.

Abstract

BACKGROUND: Double pylorus (DP), or duplication of the pylorus, is an uncommon condition that can be either congenital or acquired. Acquired DP (ADP) occurs when a peptic ulcer erodes and creates a fistula between the duodenal bulb and the distal stomach. There are a few case reports of this condition worldwide with limited data in countries with low resource settings including Ghana. Patients having acquired double pylorus have symptoms related to the underlying cause, such as peptic ulcer disease or other conditions like gastric cancer. In congenital cases, most are asymptomatic. CASE PRESENTATION: We present two cases of a 72-year-old Akan woman from Berekum in the Bono region and 15-year-old girl from Kumasi in the Ashanti region both Ghanaians who presented symptoms suggestive of peptic ulcer disease diagnosed incidentally at endoscopy, who had relief following medical treatment. The 72-year-old woman had symptoms suggestive of peptic ulcer disease over the last 5 months. She had a history of high blood pressure and took medications for both diseases. She denied the intake of alcohol and nonsteroidal anti-inflammatory drugs (NSAIDs). The 15-year-old girl had been complaining of abdominal pain for the past 6 years and had been seen at several facilities without a firm diagnosis. A biopsy of the ulcer for both patients was taken for histopathology, which later confirmed a gastric ulcer with no malignant features. The Helicobacter pylori quick test proved positive using a qualitative rapid urease test to detect the organism in gastric mucosa biopsy taken during endoscopy and the patients received triple therapy that consists of Metronidazole 400 mg three times daily, Amoxicillin 1 g twice daily, and Omeprazole 20 mg twice daily all for 10 days. This will provide more details in managing double pylorus in the aged and young populations. CONCLUSION: Double pylorus is a rare condition caused primarily by peptic ulcer disease. It may be congenital or acquired. Acquired cases are more prevalent and typically more symptomatic. Endoscopy is a reliable diagnostic modality.

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