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Research paper thumbnail of Double Pylorus in Upper Gastrointestinal Bleeding

Case Reports in Gastroenterology, 2021

Double pylorus, also known as acquired double pylorus, is a rare condition defined as a gastroint... more 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 Helicobacter pylori 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 ac...

Research paper thumbnail of Clinical Outcome Controversy in Helicobacter pylori Infection

The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

H. pylori infection can manifest as intestinal and extraintestinal disease. In this review, we su... more H. pylori infection can manifest as intestinal and extraintestinal disease. In this review, we summarize several factors that cause differences in clinical manifestations of H. pylori infection. Host inflammatory response and bacterial virulence are key in determining the pattern of acid secretion and gastritis. The acid level factor that has a greater effect, not H. pylori infection itself. Gastritis predominant in the gastric in the initial phase will produce higher acid and trigger GERD. H. pylori is also the cause of gastric adenocarcinoma. Different vacA genotypes are related to the risk of clinical manifestations such as peptic ulcer or gastric cancer. However, there is variance prevalence in some countries which can be explained through a combination of several factors including age at infection, virulence factors of H. pylori, host genetic profile, and environmental factors. Besides, important differences were found at a locus in CagA H. pylori which resulted in differences ...

Research paper thumbnail of Double Pylorus in Upper Gastrointestinal Bleeding

Case Reports in Gastroenterology, 2021

Double pylorus, also known as acquired double pylorus, is a rare condition defined as a gastroint... more 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 Helicobacter pylori 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 ac...

Research paper thumbnail of Clinical Outcome Controversy in Helicobacter pylori Infection

The Indonesian Journal of Gastroenterology, Hepatology, and Digestive Endoscopy

H. pylori infection can manifest as intestinal and extraintestinal disease. In this review, we su... more H. pylori infection can manifest as intestinal and extraintestinal disease. In this review, we summarize several factors that cause differences in clinical manifestations of H. pylori infection. Host inflammatory response and bacterial virulence are key in determining the pattern of acid secretion and gastritis. The acid level factor that has a greater effect, not H. pylori infection itself. Gastritis predominant in the gastric in the initial phase will produce higher acid and trigger GERD. H. pylori is also the cause of gastric adenocarcinoma. Different vacA genotypes are related to the risk of clinical manifestations such as peptic ulcer or gastric cancer. However, there is variance prevalence in some countries which can be explained through a combination of several factors including age at infection, virulence factors of H. pylori, host genetic profile, and environmental factors. Besides, important differences were found at a locus in CagA H. pylori which resulted in differences ...

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