Cover Image

Primary Gastric Tuberculosis Presenting as Gastric Outlet Obstruction- A Rare Entity

Coelho Victor Vijay Frederick .

Abstract


Tuberculosis is a major health problem worldwide accounting for 1.3 million deaths in 2012 alone (1). The largest number of incident cases in 2012 was reported to be in India according to the WHO 2013 guidelines. The most common manifestation of tuberculosis in India and across the world  is either pulmonary tuberculosis or an immunodeficient state. Gastrointestinal tuberculosis is not uncommon, the most  common site being the ileo-caecal region. In India it is mainly seen due to its endemicity. Gastro-duodenal involvement      in TB is very rare with a reported incidence of 0.003-0.21% of all routine autopsies (2). Here we report a case of               gastro-duodenal tuberculosis presenting as gastric outlet obstruction in an immunocompetent patient without any   evidence of pulmonary tuberculosis. The biopsy confirmed the diagnosis and the patient responded well to anti-tubercular treatment.  Even though it is rare, a high index of suspicion should be kept in mind when a patient presents with gastric outlet obstruction particularly in an endemic area.


Full Text:

PDF

References


Glaziou P, Sismanidis C, Floyd K, Raviglione M. Global Epidemiology of Tuberculosis. Cold Spring Harb Perspect Med [Internet]. 2015 Feb;5(2). Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4315920/

Sharma V, Rana SS, Gunjan D, Chhabra P, Sharma R, Bhasin DK. Primary gastric tuberculosis mimicking a submucosal tumor. J Dig Endosc. 2015 Jul 1;6(3):130.

Ecka RS, Wani ZA, Sharma M. Gastric Tuberculosis with Outlet Obstruction: A Case Report Presenting with a Mass Lesion [Internet]. Case Reports in Medicine. 2013 [cited 2017 Dec 27]. Available from: https://www.hindawi.com/journals/crim/2013/169051/ref/

Abrams JS, Holden WD. TUBERCULOSIS OF THE GASTROINTESTINAL TRACT. Arch Surg Chic Ill 1960. 1964 Aug;89:282–93.

Agrawal S, Shetty SV, Bakshi G. Primary hypertrophic tuberculosis of the pyloroduodenal area: report of 2 cases. J Postgrad Med. 1999 Mar;45(1):10–2.

Rao: Gastroduodenal tuberculosis management guidelines,... - Google Scholar [Internet]. [cited 2017 Dec 27]. Available from: https://scholar.google.com/scholar_lookup? title = Gastroduodenal+tuberculosis+management +guidelines%2C + based + on + a + large + experience + and + a + review + of + the + literature & author = Y.+G.+Rao&author=G.+K.+Pande&author=P.+Sahni&author=T.+K.+Chattopadhyay&publication_year=2004

Chazan BI, Aitchison JD. Gastric tuberculosis. Br Med J. 1960 Oct 29;2(5208):1288–90.

Tandon HD. The pathology of intestinal tuberculosis and distinction from other diseases causing stricture. Trop Gastroenterol. 1981;2:77–93.

Vij JC, Ramesh GN, Choudhary V, Malhotra V. Endoscopic balloon dilation of tuberculous duodenal strictures. Gastrointest Endosc. 1992;38(4):510–1.

Brody JM, Miller DK, Zeman RK, Klappenbach RS, Jaffe MH, Clark LR, et al. Gastric tuberculosis: a manifestation of acquired immunodeficiency syndrome. Radiology. 1986;159(2):347–8.


Refbacks

  • There are currently no refbacks.


Creative Commons License
This work is licensed under a Creative Commons Attribution-NoDerivatives 4.0 International License.

An Initiative of The Tamil Nadu Dr MGR Medical University