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A rare pylorus outlet anomaly : Pylorus on incissura angularis

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Localisation of pylorus on incissura angularis is a rare gastric outlet abnormality. Here we report a case with pylorus localised on incissura angularis, which was observed during esophagogastroduodenoscopy (EGD) due to dyspeptic complaints. A 69-year-old male patient was admitted to our outpatient clinic with dyspeptic complaints lasting for three months. The patient claimed that he has never undergone any type of endoscopic procedure before. During EGD pylorus seemed to be deformed and was localised on incissura angularis (Fig. 1). Mucosa and lumen was normal in duodenal bulb and ampulla, and papilla of Vateri was seen on its normal localisation (Fig. 2). This condition has been reported only twice in the literature (1,2). Both cases were elderly males originating from Turkey. All three cases didn’t have any surgical intervention, history of peptic ulcer disease, and signs of healed ulcers (such as scar tissue and fibrotic retractions). These findings suggest that the localisation of pylorus on incissura angularis is a congenital abnormality of gastric outlet. [Product Details...]