double pylorus (dp) is a rare condition characterized by the presence of two openings from the gastric antrum to the duodenal bulb, which may be congenital or acquired. herein, we describe a case of dp in a cirrhotic patient.

We report a 55-year-old man presenting with postprandial epigastric pain and vomiting. Barium meal study suggested two openings from the stomach to the duodenum. Endoscopy revealed double pylorus with chronic duodenal ulcer, suggesting the second opening as an acquired one.

The double pylorus is an uncommon finding and maybe congenital due to gastrointestinal duplication abnormality or more commonly secondary to peptic ulcer disease. The case we present is an elderly patient with mild dyspeptic symptoms who had an upper endoscopy as part of her investigative workup. The congenital double pylorus, being asymptomatic, may often go undetected. It is sometimes found i...

It is important to recognize that "congenital" double pylorus is a benign condition, so that extensive work-up can be avoided. Also, endoscopists should be aware of the double pylorus and demonstrate extra caution during endoscopic retrograde cholangiopancreatography (ERCP).