Pyloric canal ulcer

Fig. 4.8. Pyloric canal ulcer. A small ulcer in the distal pyloric canal with a normal endoscopy (arrow). There is also an impression on the base of the superior duodenal fornix due to oedema...

These include ulcers in the distal duodenum, the presence of a double pyloric canal (Fig. 5.8b,c), or multiple recurrent anastomotic ulcers. Other findings include a non-dilated non-obstructed stomach filled with diluted barium due to hypersecretion, dilatation of the duodenum and proximal small bowel, sluggish gastric peristalsis, and thickening of gastric and duodenal folds (Berg and Wolfe 1991 Hirschowitz 1997). 

Fig. 5.8a-c. Other benign gastroduodenal ulcers a Recurrent anastomotic ulcer in a patient with previous gastroenterostomy. Note that the ulcer is just on the jejunal side of the anastomosis, b Double pyloric canal on a double contrast barium meal in a patient with Zollinger-Ellison syndrome and c endoscopic view of a double pyloric canal (separate patient)... 

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