Gastric ectopic pyloric opening: an unusual case

Stomach is the most dilated part of the digestive tube. The shape of the stomach could vary frequently without any clinical symptoms. Abnormality of pylorus including double pylorus and congenital pyloric stenosis has been reported but pyloric ectopic opening has not been reported before. We found a rare case of pyloric ectopic opening in the stomach body with a “hammer” shape stomach in a 72-year-old man. The patient complained of upper left abdominal with no past medical history or surgery history. The double-contrast examination showed a “hammer” shape stomach, with the pylorus opening high at the lesser curvature and enlarged distal end of the stomach. The gastrointestinal endoscopy showed that the pyloric antrum was approximately 3 cm below the cardia with a round and poor functioning opening. No obvious abnormalities in the bulb and descending part of the duodenum were observed. A large ulcer with whitish exudate covering the base was found on the posterior wall. Histological examination of the ulcer showed broken mucosal glands with atypical hyperplasia and focal carcinogenesis. This case shows a probably congenital pyloric ectopic opening in the gastric body with a “hammer”-shaped stomach, adding a new gastric morphological variation.