The multi-channelled pylorus.

The entity of multiple pyloric channels may be congenital but the majority are acquired lesions representing fistulae secondary to peptic ulcer disease in the pyloroduodenal region. The fistula usually joins the lesser curvature of the stomach with the superior aspect of the duodenal bulb. The multichannelled pylorus produces a characteristic radiological appearance on barium mean examination with a double or split barium column in the region of the pylorus. Four cases are described and illustrated.