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From questions on page 1664

Figure 1 (see question) shows an ulcer at the superior aspect of the pylorus (white arrow) and a double pyloric channel (double arrow head) into a single first part of the duodenum. This rare complication of peptic ulcer disease is called double pylorus or antro-duodenal fistula.

Figure 1 Endoscopic appearance of gastric antrum at repeat gastroscopy.

A CLO test was positive …

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