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[Primary gastric tuberculosis]
E Nussinson1, O Segol, L Landman-Merdler
1Gastroenterology Unit, Central Hospital of the Emek, Afula.
Harefuah
|September 1, 1995
Summary
Primary gastric tuberculosis (TB) is rare but should be considered for antral lesions, especially in immigrant communities. Early diagnosis and chemotherapy led to an excellent response in a recent case.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Pulmonology
Background:
- Intestinal tuberculosis (TB) accounts for 5% of all TB cases, with gastric TB being rare (0.1-2%).
- Gastric TB is typically secondary to pulmonary TB, presenting as antral infiltrative lesions on endoscopy.
- Primary gastric TB is exceptionally rare, with only 8 reported cases.
Observation:
- A 55-year-old woman presented with abdominal pain and gastric outlet obstruction.
- Endoscopic examination revealed antral infiltrative lesions.
- Diagnosis was supported by positive Mantoux test, acid-fast bacilli in gastric juice, and positive TB culture from gastric lavage.
Findings:
- Endoscopic biopsies showed granulomas, but no acid-fast bacilli.
- Despite negative bacilli on biopsy, the overall clinical picture and microbiological tests confirmed primary gastric TB.
- The patient showed an excellent response to antituberculous chemotherapy.
Implications:
- The increasing relative incidence of extra-pulmonary TB necessitates considering primary gastric TB in differential diagnoses.
- This case highlights the importance of comprehensive diagnostic approaches for rare presentations of TB.
- Early recognition and treatment of primary gastric TB can lead to favorable outcomes.