Primary gastroduodenal tuberculosis complicated with acute pancreatitis: a rare case report and literature review

Background Tuberculosis (TB) is a major health problem worldwide. Even in highly prevalent countries, primary gastroduodenal tuberculosis is a rare manifestation of extrapulmonary tuberculosis. In recent years, as the incidence of tuberculosis has increased year by year, the occur of gastroduodenal tuberculosis has also increased. Endoscopy is an important tool for diagnosing gastroduodenal tuberculosis. The performance of gastroduodenal tuberculosis under endoscopy is often non-specific, which may imitate other benign or malignant gastroduodenal diseases. Diagnosis of gastroduodenal tuberculosis relies on a combination of endoscopy and guided biopsy. Case presentation Here, we report a rare and interesting case of gastroduodenal tuberculosis with acute pancreatitis. The case initially mimicked gastroduodenal ulcers in morphology and appeared in a middle-aged person with normal immunity but with prolonged fever and abdominal pain. The disease was diagnosed through endoscopy and guided biopsy, and it responded well to antituberculosis drugs. Conclusions Clinicians must remember that even in the absence of immunodeficiency, as in this case, tuberculosis can affect any part of the gastrointestinal tract.

Primary Gastroduodenal Tuberculosis Complicated With Acute Pancreatitis: A Rare Case Report and Literature Review

Background: Tuberculosis (TB) is a major health problem worldwide. Even in highly prevalent countries, primary gastroduodenal tuberculosis is a rare manifestation of extrapulmonary tuberculosis. In recent years, as the incidence of tuberculosis has increased year by year, the occur of gastroduodenal tuberculosis has also increased. Endoscopy is an important tool for diagnosing gastroduodenal tuberculosis. The performance of gastroduodenal tuberculosis under endoscopy is often non-specific, which may imitate other benign or malignant gastroduodenal diseases. Diagnosis of gastroduodenal tuberculosis relies on a combination of endoscopy and guided biopsy. Case presentation: Here, we report a rare and interesting case of gastroduodenal tuberculosis with acute pancreatitis. The case initially mimicked gastroduodenal ulcers in morphology and appeared in a middle-aged person with normal immunity but with prolonged fever and abdominal pain. The disease was diagnosed through endoscopy and guided biopsy, and it responded well to antituberculosis drugs. Conclusions: Clinicians must remember that even in the absence of immunodeficiency, as in this case, tuberculosis can affect any part of the gastrointestinal tract.

Nonsurgical management of gastroduodenal tuberculosis: Nine-year experience from a tertiary referral center

Background and study aims Gastroduodenal tuberculosis (GDTB) is an uncommon disease. Surgery has been standard of care both for diagnosis and management of GDTB. The aim of this study was to evaluate the efficacy of non-surgical management of GDTB using a combination of anti-tuberculous therapy (ATT) along with endoscopic dilatation of the tuberculous stricture. Patients and methods Patients suspected to have gastroduodenal TB were evaluated: clinical, endoscopic, radiological, and histopathological data were recorded. Patients in whom a definite diagnosis of tuberculosis could not be confirmed on mucosal biopsies underwent endoscopic mucosal resection (EMR). Patients were treated with ATT and endoscopic dilatation was done if indicated. Patients were followed up to evaluate clinical, radiological and endoscopic response. Results Over a 9-year period from 2009 to 2017, 52 patients (mean age 28.5yrs) were diagnosed with GDTB. The most common presenting symptoms were vomiting (n = 51, 98 %) and weight loss (n = 52,100 %). The most common anatomical site of involvement was D1–D2 junction (n = 22, 42 %). Histopathological diagnosis could be made in 43 patients (82.6 %); 36 (69 %) on mucosal biopsies and in 7 of 10 patients (70 %) who underwent snare biopsy/EMR. Endoscopic dilatation was done in 37 patients (71 %) and median dilatation sessions were two. Failure of endotherapy occurred in four patients (7.6 %). All responders had complete amelioration of symptoms after 4 to 6 weeks of combination therapy. Median period of follow-up was 23.5 months and none of the patients reported any recurrence of symptoms. Conclusion ATT and endoscopic dilatation combined has a high success rate in management of GDTB and should be considered the standard of care.

Primary duodenal tuberculosis - A rare case report

Gastroduodenal tuberculosis is uncommon even in parts of world where tuberculosis is endemic and accounts for 2.3 % of abdominal tuberculosis. We present here a case of duodenal tuberculosis who presented with vomiting, pain abdomen and weight loss. Duodenoscopy revealed mucosal ulceration and nodularity with marked enlarged and erythematous surrounding folds. Histopathology of duodenum showed features of tuberculosis.

Gastroduodenal Tuberculosis: A Case Series and Review of Literature

Gastroduodenal tuberculosis is infrequently seen in day-to-day clinical practice with few cases reported in the literature. It is usually associated with features of gastric outlet obstruction. This is a case series of 4 patients with 2 of them having associated lower gastrointestinal involvement. One of them resembled a growth in the cardia of the stomach which responded to antitubercular drugs. Another had duodenal erosions with portal lymph node enlargement which responded to antitubercular drug treatment. None of the patients required surgical management. Gastroduodenal tuberculosis should be considered with a high degree of suspicion when patients present with gastric outlet obstruction or with endoscopic evidence of ulceronodular disease in areas endemic for tuberculosis.