Korean J Gastroenterol.  2022 Mar;79(3):126-129. 10.4166/kjg.2022.018.

Gastric Ectopic Pyloric Opening with Gastric Ulcer: A Rare Case

• Koh M
• Jang JS

• KMID: 2527480
• DOI: http://doi.org/10.4166/kjg.2022.018

Abstract

The stomach temporarily stores food and secretes gastric juices to break down and digest food. The normal process is the movement of food digested from the stomach to the duodenum, with the pylorus as a passageway. This paper reports the case of a patient with an ectopic gastric pylorus who presented with gastrointestinal bleeding. A 62-year-old man complained of melena with mild dizziness and nausea. An endoscopic examination revealed a gastric ulcer, approximately 1 cm in diameter, and exposed blood vessels on the posterior wall of the upper body. No normal pyloric structure was observed in the distal antrum, and an opening leading to the duodenum was noted in the posterior wall of the upper body adjacent to the ulcer. This case presents a congenital pyloric ectopic opening in the upper body of the stomach, not in the distal antrum, suggesting a rare gastric morphological variation.

Keyword

Ectopic pylorus; Gastric abnormality; Gastric ulcer

Figure

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  Fig. 1 Endoscopic finding. (A) J-turn view. A gastric ulcer in the posterior wall of the upper body and an opening leading to the duodenum. (B) Endoscopic hemostasis was performed with hemoclips.

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  Fig. 2 Abdominal computed tomography scan. (A) Transverse view; the pylorus opened to the side of the posterior wall of the stomach (arrow). (B) Coronal view; a hemoclip is observed near the ectopic pyloric opening in the upper body, and the distal antrum is observed as a blind duct (arrows).

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  Fig. 3 Schematic figure of the stomach. (A) Normal stomach structure. (B) Gastric ectopic pyloric opening with gastric ulcer.

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