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Primary gastric tuberculosis presenting as pyloric outlet obstruction
J L Tromba1, R Inglese, B Rieders
1Department of Gastroenterology, Jamaica Hospital, New York.
The American Journal of Gastroenterology
|December 1, 1991
Summary
A rare case of primary gastric tuberculosis (GTB) is presented in a Haitian male with peptic ulcer disease. Diagnosis was confirmed via biopsy and culture, highlighting GTB as an uncommon cause of gastric outlet obstruction.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pathology
Background:
- Peptic ulcer disease (PUD) can present with complex symptoms.
- Gastric outlet obstruction (GOO) requires thorough etiological investigation.
Observation:
- A 38-year-old male with PUD history presented with persistent vomiting and weight loss.
- Barium studies and endoscopy revealed GOO with prepyloric ulcerations.
- Surgical exploration identified enlarged celiac lymph nodes and gastric wall abnormalities.
Findings:
- Endoscopic biopsies showed chronic gastritis.
- Gastric and lymph node biopsies revealed necrotizing granulomas.
- Acid-fast bacilli cultures confirmed Mycobacterium tuberculosis, indicating primary gastric tuberculosis.
Implications:
- Primary gastric tuberculosis is an extremely rare cause of GOO.
- Definitive diagnosis relies on tissue biopsy and microbiological culture.
- This case underscores the importance of considering uncommon infections in refractory gastrointestinal conditions.