Symptomatic double-channel pylorus

Abstract

A patient with a previous vagotomy and pyloroplasty was evaluated for symptoms of gastric outlet obstruction. Endoscopy revealed a thick, fibrous bridge that created a dual-channel pylorus. Symptomatic improvement was not achieved with balloon dilatation. Surgery was avoided by dividing the tissue bridge endoscopically with a sphincterotome. Since reestablishing a normal pyloric aperture, the patient's symptoms have been alleviated. This is the first description of this minimally invasive technique in the management of a symptomatic double-channel pylorus.

Symptomatic Multichannel Pylorus as a Complication of Previous Peptic Ulcer Surgery

“…The majority of patients can be managed medically, although 20% of patients with refractory symptoms may require surgical interventions. The successful treatment of double pylorus with a biliary sphincterotomy has also been reported [4]. Our patient's history of truncal vagotomy and Jaboulay-type gastroduodenostomy, and the absence of data about the presence of In conclusion multichannelled pylorus is a rare abnormality and usually is considered to be an acquired condition that occurs most commonly secondary to chronic peptic ulcer disease.…”

Double Pylorus: Report of a Case With Endoscopic Follow-Up and Review of the Literature

“…Endoscopic treatment, using biliary sphincterotome for dividing the bridge tissue, is feasible to be performed. Furthermore, surgical intervention should be considered when endoscopic treatment has failed or a peptic ulcer persists despite the maximum medical therapy due to contribution of double pylorus to bile acid reflux or in the case of free perforation [ 9 , 10 ].…”