Doble piloro adquirido: una complicación poco usual de enfermedad úlceropeptica. A propósito de un caso / DOUBLE ACQUIRED PYLORUS: AN UNUSUAL COMPLICATION OF PEPTIC ULCER DISEASE. ABOUT A CASE

El Doble Píloro (DP) es un hallazgo endoscópico inusual en el que el antro gástrico se conecta al bulbo duodenal por dos orificios separados por un septo, tabique o puente. Su etiología puede ser congénita o adquirida siendo esta última la forma más común como complicación de una enfermedad ulcero péptica (EUP). La mayoría de las fistulas están localiza­das en la curvatura menor de antro gástrico. En los casos de DP adquirido se han descrito tres teorías en cuanto a su forma­ción. Puede presentarse con dolor en epigástrico, dispepsia o hemorragia digestiva aunque en ocasiones es un hallazgo ca­sual endoscópico o radiológico. En este caso presentamos a un paciente quien acude con clínica de Hemorragia Digestiva Superior a quien se le realiza gastroscopia donde se eviden­cia este hallazgo poco usual el cual fue confirmado mediante estudio radiológico. En general el pronóstico es favorable.

The Double Pylorus (DP) is an unusual finding in the gastros­copy where the gastric antrum and the duodenal bulb is con­nected to by two holes separated by a septum or bridge. Its etiology may be congenital or acquired the latter being the most common form as a complication of peptic ulcer disease (EUP). Most fistulas are located on the lesser curvature of the gastric antrum. There have been described three theories in the formation of acquired DP. It may present with epigastric pain, dyspepsia or gastrointestinal bleeding but sometimes it is an endoscopic or radiological incidental finding. We present a patient who presents with upper gastrointestinal bleedings­ymptoms in whom a gastroscopy where performed with this unusual finding which was confirmed by radiological study. In general the prognosis is favorable.

The clinical value of multi-slice spiral CT in assessing the risk of esophageal bleeding / 中国基层医药

Objective To investigate the clinical value of multi-slice spiral CT in the evaluation of esophageal variceal bleeding .Methods 50 cirrhosis patients with esophageal varices received multi-slice spiral CT and gastroscopy detection .The application value of multi-slice CT in the assessment of esophageal bleeding was evaluated according to the results of gastroscopy detection .Results CT angiography score had significantly positive correlation with the severity of endoscopic varices and endoscopic red color sign (r=0.762,0.687,all P<0.01).The sensitivity and specificity of CT angiography score in diagnosis of endoscopic red signs RC 3 were 76.92% and 92.50%. Conclusion The results of multi-slice CT and gastroscopy are positively correlated with the severity of esophageal varices,which can be used to predict the risk of esophageal bleeding .