Double pylorus is a rare gastrointestinal tract abnormality that is classified as congenital or acquired. Most cases are of the acquired type and result from intramural penetration of gastric or duodenal ulcers. We report a 76-year-old man with chronic kidney disease and gouty arthritis receiving non-steroidal anti-inflammatory drug (NSAID) who presented with chronic abdominal pain and tarry stool. Esophagogastroduodenoscopy (EGD) showed two openings at pre-pyloric antrum. Based on these findings, double pylorus was diagnosed. Etiology, clinical presentation, endoscopic characteristics, and treatment of this disease are reviewed.
