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[Non-healing gastric ulcer].

Ch Gubler1, T Ehmann, Ch Meyenberger

  • 1Fachbereich Gastroenterologie, Departement Innere Medizin, Kantonsspital St. Gallen.

Deutsche Medizinische Wochenschrift (1946)
|July 29, 2003
PubMed
Summary

Tuberculosis can cause non-healing gastric ulcers, particularly in immigrants from endemic regions. Early diagnosis and appropriate tuberculostatic therapy are crucial for successful treatment.

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Internal Medicine

Background:

  • Gastrointestinal tuberculosis (GIT) is a rare condition, often presenting with non-specific symptoms.
  • Differential diagnosis of non-healing gastric ulcers typically includes Helicobacter pylori infection and malignancy.

Observation:

  • A 47-year-old Angolan immigrant presented with upper abdominal pain, fever, weight loss, and night sweats.
  • Abdominal ultrasound revealed enlarged lymph nodes at the liver hilum. Endoscopy showed multiple gastric ulcers with positive Helicobacter pylori testing.
  • Lymph node aspirate showed granulomatous inflammation, and subsequent culture identified multiresistant Mycobacterium tuberculosis.

Findings:

  • Initial treatment for Helicobacter pylori and proton pump inhibitors did not resolve epigastric pain or gastric ulcers.
  • The patient experienced rapid improvement and uncomplicated recovery after initiating tuberculostatic therapy for Mycobacterium tuberculosis.

Implications:

  • Tuberculosis should be considered in the differential diagnosis of refractory gastric ulcers, especially in immigrant populations from tuberculosis-endemic areas.
  • This case highlights the importance of considering uncommon etiologies in persistent gastrointestinal symptoms.
  • Prompt identification and treatment of gastrointestinal tuberculosis are essential for favorable patient outcomes.

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