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Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
Duodenal stenosis secondary to tuberculosis
Ashok Y Kshirsagar1, Sujata R Kanetkar, Yogesh B Langade
1Department of Surgery, Krishna Institute of Medical Sciences, Karad, Maharashtra, India. drayk@indiatimes.com
International Surgery
|December 1, 2009
Summary
A young man with duodenal obstruction due to tuberculosis underwent surgery and antituberculous treatment. This case highlights the importance of considering tuberculosis in duodenal obstruction, even in the absence of typical symptoms.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Surgical Pathology
Background:
- Duodenal obstruction is a serious condition requiring prompt diagnosis and management.
- Tuberculosis (TB) can manifest in various extrapulmonary sites, including the gastrointestinal tract.
- Gastrointestinal TB is often challenging to diagnose due to nonspecific symptoms.
Observation:
- An 18-year-old male presented with epigastric pain, vomiting, appetite and weight loss, fever, and irregular bowel movements.
- Barium meal follow-through showed a dilated stomach and duodenum with a stenotic lesion in the second part.
- Endoscopic biopsy revealed acute on chronic nonspecific duodenitis with fibrosis.
Findings:
- Surgical bypass (isoperistaltic antecolic gastrojejunostomy) was performed for the duodenal obstruction.
- Biopsy of enlarged lymph nodes revealed changes consistent with tuberculosis.
- The patient was initiated on antituberculous drugs postoperatively.
Implications:
- This case underscores the importance of considering gastrointestinal tuberculosis in the differential diagnosis of duodenal obstruction.
- Early diagnosis and appropriate treatment of TB are crucial for favorable outcomes.
- Multidisciplinary management involving gastroenterologists, surgeons, and infectious disease specialists is essential.
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