Duodenal tuberculosis--a rare case report and review of literature

Pol Przegl Chir. 2013 Aug;85(8):464-6. doi: 10.2478/pjs.2013.85.8.464.

Abstract

Extrapulmonary tuberculosis is rare and often difficult to diagnose infection. We report a case of duodenal tuberculosis, who presented with upper gastrointestinal symptoms. There was evidence of obstruction in the third part of duodenum (D3) on oesophagogastro endoscopy, barium meal follow through and CT scan of abdomen. On exploration there was thickening of D3 and D4 causing luminal obstruction. Resection of stricturous segment with end-to-side duodenojejunostomy was done. Biopsy of the diseased segment was tubercular. Antitubercular treatment was given to the patient for 6 months and he is doing well on follow up (1 year after surgery). Duodenal tuberculosis being the rarest form of intestinal tuberculosis poses great difficulty in diagnosis. High index of suspicion supported by radiological investigation, exploratory laparotomy and histopathological examination of the tissue can only lead to a definitive diagnosis of this rare condition. Treatment is both surgical which involves resection or by-pass for an obstructive lesion and medical which includes antitubercular therapy.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Adult
  • Biopsy
  • Duodenal Diseases / diagnosis*
  • Duodenal Diseases / pathology*
  • Duodenal Diseases / surgery
  • Duodenal Obstruction / diagnosis
  • Duodenal Obstruction / etiology
  • Duodenal Obstruction / surgery
  • Endoscopy, Digestive System
  • Humans
  • Laparotomy
  • Male
  • Rare Diseases
  • Tomography, X-Ray Computed
  • Tuberculosis, Gastrointestinal / diagnosis*
  • Tuberculosis, Gastrointestinal / pathology*
  • Young Adult