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Duodenal tuberculosis presenting as gatric outlet obstruction
Journal of Surgical Case Reports
|June 25, 2014
Summary
Isolated duodenal tuberculosis is rare and difficult to diagnose preoperatively. This case highlights a successful surgical and therapeutic approach for gastric outlet obstruction caused by duodenal tuberculosis.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Infectious Diseases
Background:
- Tuberculosis of the stomach and duodenum is exceptionally rare, even in individuals with known pulmonary or intestinal tuberculosis.
- Preoperative diagnosis of isolated duodenal tuberculosis presents a significant challenge for surgical teams.
- Gastric outlet obstruction is a potential complication of duodenal tuberculosis.
Purpose of the Study:
- To report a case of isolated duodenal tuberculosis presenting as gastric outlet obstruction.
- To discuss the diagnostic challenges and management strategies for this rare condition.
Main Methods:
- A 42-year-old male presented with symptoms of gastric outlet obstruction.
- Esophago-gastro-duodenoscopy (UGIE) showed duodenal fold thickening; biopsy was inconclusive.
- Contrast-enhanced computed tomography (CECT) of the abdomen revealed duodenal wall thickening and mesenteric fat stranding.
- Exploratory laparotomy identified duodenal growth and peritoneal seedlings, with tissue biopsy performed.
- Surgical intervention included gastro-jejunostomy and jejuno-jejunostomy.
Main Results:
- Histopathological examination confirmed gastrointestinal tuberculosis.
- The patient received anti-tubercular therapy post-operatively.
- The patient achieved a complete cure.
Conclusions:
- Isolated duodenal tuberculosis is a rare entity that can mimic other gastrointestinal pathologies.
- A combination of advanced imaging, surgical exploration, and histopathological analysis is crucial for diagnosis.
- Prompt diagnosis and appropriate anti-tubercular therapy lead to successful patient outcomes.
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