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Duodenal tuberculosis presenting as gastric outlet obstruction: A case report
Haydee Buluran Flores1, Felix Zano, Ena Lyn Ang
1Haydee Buluran Flores, Felix Zano, Ena Lyn Ang, Norberto Estanislao, Philippine General Hospital, Manila City 1000, Philippines.
Abstract:
Gastric outlet obstruction is commonly associated with malignancies and peptic ulcer disease. However, when no malignancy is seen and the patient is non-responsive to conventional peptic ulcer treatment, other etiologies need to be explored. We report a case of gastric outlet obstruction due to duodenal tuberculosis. The patient is a 31 year old male who presented with 1 year history of recurrent epigastric pain and an acute episode of vomiting. Endoscopy revealed duodenal stricture. Computed tomography scan showed pyloroantral thickening. The patient was referred to the surgery service and underwent an exploratory laparotomy and gastrojejunostomy. A duodenal mass and calcified lymph nodes were noted on exploration and biopsy revealed a tuberculous origin. The patient was started on anti-tuberculosis medications and had improved on discharge. Gastroduodenal tuberculosis is rare and pyloric stenosis resulting from tuberculosis is even rarer. This, however, should be considered in patients who come from areas where the disease is endemic.
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