Pyloric stenosis due to peptic ulceration.
A 45-year old male worker presented with a 3-month
history of vomiting 4 hours after each meal. He gave a history of dyspepsia for the last 20 years, and had been treated with several courses of H2-blockers.
Upper endoscopy revealed a dilated enlarged stomach with deformity and stenosis of duodenal bulb. The H.pylori urease test was positive.
He remained symptomatic 2 months after H.pylori eradication with PPI -based quadruple therapy.
This is the small bowel follow through in this patient - he had both pyloric stenosis and pneumatosis cystoides intestinalis of the small intestine.
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