{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T12:53:32Z","timestamp":1786539212759,"version":"build-2736575974"},"reference-count":11,"publisher":"S. Karger AG","issue":"1","license":[{"start":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T00:00:00Z","timestamp":1615420800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2021,3,11]],"date-time":"2021-03-11T00:00:00Z","timestamp":1615420800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Case Rep Gastroenterol"],"abstract":"<jats:p>Double pylorus, also known as acquired double pylorus, is a rare condition defined as a gastrointestinal fistula connecting stomach antrum and duodenal bulb. The prevalence of double pylorus ranges from 0.001 to 0.4% by esophagogastroduodenoscopy (EGD). Although the etiology is unknown, the formation of double pylorus is related to &lt;i&gt;Helicobacter pylori&lt;\/i&gt; infection and the use of non-steroidal anti-inflammatory drugs (NSAID). The development of the occurrence of double pylorus is still unknown, but many systemic diseases play a role. We present the case of a 59-year-old man who was admitted to Dr. Soetomo General Hospital with hematemesis and melena. The patient had a history of diabetes mellitus since 3 years and consumption of medicinal herbs for myalgia, which was suspected of NSAIDs for the past 5 months. The patient had anemia with hemoglobin at 8.3 g\/dL, enterogenous azotemia with blood urea nitrogen 28 mg\/dL and serum creatinine 1.14 mg\/dL. At EGD, double pylorus was found and accompanied by gastric ulcer, a giant white base ulcer, part of it covered by clotting without any sign of active bleeding. Biopsy revealed chronic inactive gastritis, and no &lt;i&gt;H. pylori&lt;\/i&gt; was found. Treatment mainly depends on gastrointestinal acid suppression through a proton pump inhibitor (PPI). The patient was given a high-dose PPI and a mucosal protective agent. He was treated for 1 week and had improved complaints. <\/jats:p>","DOI":"10.1159\/000513804","type":"journal-article","created":{"date-parts":[[2021,3,23]],"date-time":"2021-03-23T16:30:28Z","timestamp":1616517028000},"page":"332-337","source":"Crossref","is-referenced-by-count":8,"title":["Double Pylorus in Upper Gastrointestinal Bleeding"],"prefix":"10.1159","volume":"15","author":[{"given":"Heasty","family":"Oktaricha","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Miftahussurur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"127","published-online":{"date-parts":[[2021,3,11]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/S1995-7645(12)60087-X"},{"key":"ref2","doi-asserted-by":"publisher","DOI":"10.3748\/wjg.v22.i6.2153"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.14740\/gr960w"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.34172\/mejdd.2020.174"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/j.cgh.2008.06.023"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijge.2011.09.010"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.14740\/gr1248"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1007\/s10620-005-3018-6"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.1007\/s12664-014-0533-4"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1093\/jscr\/rjz096"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.5152\/balkanmedj.2014.13207"}],"container-title":["Case Reports in Gastroenterology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/513804","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.karger.com\/Article\/Pdf\/513804","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,4,23]],"date-time":"2025-04-23T16:18:19Z","timestamp":1745425099000},"score":1,"resource":{"primary":{"URL":"https:\/\/karger.com\/article\/doi\/10.1159\/000513804"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2021,3,11]]},"references-count":11,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2021,5,3]]}},"URL":"https:\/\/doi.org\/10.1159\/000513804","archive":["Portico"],"relation":{},"ISSN":["1662-0631"],"issn-type":[{"value":"1662-0631","type":"electronic"}],"subject":[],"published":{"date-parts":[[2021,3,11]]}}}