ABSTRACT
We report on a 29-year-old Pakistani man who presented to the clinic with epigastric pain, of one-month duration. He did not report fever, cough, vomiting blood, passing black stools, loss of appetite or diarrhea. However, he had lost 7 kg since his symptoms had begun. Clinical examination was unremarkable. Laboratory results were within normal limits. An abdominal CT scan showed a mass with enhancement in the stomach. Gastric endoscopy revealed an ulcerative mass in the fundus. An endoscopic-biopsy specimen revealed caseating granulomas with acid-fast bacilli. The patient was diagnosed to have primary gastric tuberculosis, and antituberculous medications were initiated. Cultures of the gastric mass subsequently grew Mycobacterium tuberculosis sensitive to isoniazid and rifampcin. Follow-up after six months showed a good response to treatment; an upper gastrointestinal tract endoscopy after six months was normal.
Subject(s)
Adult , Humans , Male , Stomach Diseases/diagnosis , Tuberculosis, Gastrointestinal/diagnosis , Antitubercular Agents/therapeutic use , Follow-Up Studies , Gastroscopy , Gastric Fundus/microbiology , Immunocompetence , Isoniazid/therapeutic use , Rifampin/therapeutic use , Stomach Diseases/drug therapy , Stomach Diseases/microbiology , Tomography, X-Ray Computed , Tuberculosis, Gastrointestinal/drug therapyABSTRACT
Tuberculose pode envolver qualquer parte do trato gastrointestinal, entretanto a localização gástrica é extremamente rara. Tuberculose gástrica pode mimetizar úlcera péptica ou neoplasia gástrica maligna, porém hemorragia digestiva alta é manifestação extremamente incomum da tuberculose gástrica. Nós relatamos um caso de tuberculose disseminada, em uma paciente com SIDA com repetidos episódios de melena e hematêmese. A biópsia realizada evidenciou micobacteriose antral, com presença de bacilos álcool-ácido resistentes na área ulcerada (AU)
Tuberculosis may involve any part of the gastrointestinal (GI) tract. However gastric involvement is extremely rare. Gastric tuberculosis may simulate peptic ulcer or gastric malignancy, but upper GI bleeding is an extremely uncommon manifestation. We report a case of disseminated tuberculosis in a patient with AIDS, with repeated episodes of melena and hematemesis. A biopsy revealed antral mycobacteriosis with the presence of acidfast bacilli in the ulcerated area (AU)
Subject(s)
Humans , Female , Adult , Tuberculosis, Gastrointestinal/complications , Gastrointestinal Hemorrhage/etiology , Tuberculosis, Gastrointestinal/pathology , Tuberculosis, Gastrointestinal/diagnostic imaging , Comorbidity , HIV Infections/immunology , Diagnosis, Differential , Gastrointestinal Hemorrhage/diagnosisABSTRACT
Tuberculosis of the stomach is quite rare, both as a primary or secondary infection. It can present as a facet of a multiorgan disease process or may result from immunodeficiency. Here, we report a rare, interesting case of gastric tuberculosis which morphologically mimicked advanced gastric cancer in a young, immunocompetent patient presenting with hematemesis and melena. The disease was diagnosed by biopsy, and responded well to antituberculosis medication without surgery. Clinicians must bear in mind that, even in the absence of immunodeficiency, as in this case, tuberculosis can involve any site in the gastrointestinal tract and may present with a variety of characteristics. Gastric tuberculosis should always be part of the differential diagnosis of chronic infiltrative lesions in the stomach.
Subject(s)
Male , Humans , Adult , Tuberculosis, Gastrointestinal/diagnosis , Stomach Neoplasms/diagnosis , Diagnosis, Differential , Antitubercular Agents/therapeutic useABSTRACT
Gastrointestinal tuberculosis has steadily decreased with the development of anti-tuberculous treatment, improvement of personal hygiene resulting from a rise in the standard of living, early diagnosis of pulmonary tuberculosis, and so forth. However, gastrointestinal tuberculosis can occasionally be found clinically in South Korea where the prevalence of tuberculosis is as much as 2.2%. Prevalence of gastric tuberculosis is low, compared with other gastrointestinal tuberculosis. While there have recently been several reports on the occurrence of gastric tuberculosis and duodenal tuberculosis assuming the form of malignancy, few cases have been reported of the tuberculosis affecting stomach and duodenum simultaneously. In this article we report the case in which tuberculosis affects both stomach and duodenum, which was initially misconceived as a double primary cancer.
ABSTRACT
We experienced a case of primary gastric tuberculosis presented with melena. A 61-year-old male was admitted with epigastric pain and melena. Upper endoscopy revealed an irregular shaped gastric ulcer on the posterior wall of the body. Histological examination of endoscopic specimen revealed chronic inflammation with fibrosis, granulomas and acid-fast bacilli. Cultures for acid-fast bacilli subsequently grew Mycobacterium tuberculosis. There was no evidence of the tuberculous lesion anywhere else. Primary gastric tuberculosis remains an extremely uncommon clinical entity; the definitive diagnosis is made by biopsy and positive culture for the organism. We report a case of primary gastric tuberculosis with review of the literature.
Subject(s)
Humans , Male , Middle Aged , Biopsy , Diagnosis , Endoscopy , Fibrosis , Granuloma , Inflammation , Melena , Mycobacterium tuberculosis , Stomach Ulcer , TuberculosisABSTRACT
The incidence of Tuberculosis among the patients with end-stage renal disease(ESRD) has increased up to 16 times of that in the general population. The impairment of the cellular immunity in the ESRD patients may have a role in the pathogenesis. Extrapulmonary tuberculous manifestations such as lymph node, peritoneum, and pleura involvement are more frequent in the ESRD patients than in the general population. However, there has been no case of upper gastrointestinal(UGI) bleeding as a result of a gastric tuberculosis in the ESRD patient on hemodialysis. Here we report an unusual case of a hemodialysis patient with UGI bleeding secondary to a tuberculous gastric ulcer. A 31-year-old female on hemodialysis was admitted with melena. Endoscopy revealed a benign gastric ulcer with a visible bleeding vessel at the base, located in the anterior wall of the antrum. An exploratory laparotomy showed multiple, round, small and yellow nodules on the visceral peritoneum as well as a 1-cm sized gastric ulcer. After gastric resection, a histological examination including peritoneal nodules demonstrated chronic granulomatous inflamation with caseous necrosis and giant cells. The patient has been on antituberculosis medication and followed up in the outpatient department without any event for 8 months.
Subject(s)
Adult , Female , Humans , Endoscopy , Giant Cells , Hemorrhage , Immunity, Cellular , Incidence , Kidney Failure, Chronic , Laparotomy , Lymph Nodes , Melena , Necrosis , Outpatients , Peritoneum , Pleura , Renal Dialysis , Stomach Ulcer , TuberculosisABSTRACT
Gastric tuberculosis is quite rare and usually combined with pulmonary tuberculosis. Its diagnosis is so difficult as it is often unsuspected. We report a patient with gastric tuberculosis who presented with hematemesis in Korea. Upper endoscopy showed large, deep penetrating ulcer containing an exposed vessel and adherent clot in the body. Gastric biopsies revealed only chronic inflammation and no evidence of granuloma or malignancy. Diffuse mural thickening was noted on abdominal CT. The diagnosis was made postoperatively following gastrectomy for bleeding gastric ulcer. Microscopic examination of resected stomach showed peptic detritus and noncaseating granulomas. However, multiple caseating granulomas with Lagerhan's giant cells were found on the examination of lymph nodes. The patient was treated with antituberculous therapy for 12 months without any complications.
Subject(s)
Humans , Biopsy , Diagnosis , Endoscopy , Gastrectomy , Giant Cells , Granuloma , Hematemesis , Hemorrhage , Inflammation , Korea , Lymph Nodes , Stomach , Stomach Ulcer , Tomography, X-Ray Computed , Tuberculosis , Tuberculosis, Pulmonary , UlcerABSTRACT
A 34-year-old female presented with persistent indigestion and epigastric pain for several weeks. Upper GI series and abdominal CT revealed a submucosal tumor in the antrum of the stomach. Gastrofi beroscopy revealed a multi-lobulated protruding mass in the proximal antrum. Endoscopic biopsies were consistent with chronic inflammation with a focal ill-defined granulomatous area and lymphoid aggravation. At the time of operation, a hard mass was palpated at the greater curvature side of the proximal antrum, and large lymph nodes were noted along the gastroepiploic vessels. Biopsies of the wall of the stomach and the lymph nodes demonstrated caseous granulomas. Cultures for acid-fast bacilli subsequently grew Mycobacterium tuberculosis. Gastric tuberculosis remains an extremely rare clinical entity. We experienced a case of gastric tuberculosis, so we report it with a review of some articles.
Subject(s)
Adult , Female , Humans , Biopsy , Dyspepsia , Granuloma , Inflammation , Lymph Nodes , Mycobacterium tuberculosis , Stomach , Tomography, X-Ray Computed , TuberculosisABSTRACT
Gastric tuberculosis is a rare disease and is usually secondary to pulmonary or intestinal tuberculosis. Only a few cases of gastric tuberculosis have been reported in the literature. In most cases, gastric tuberculosis exists as an ulcerating lesion, whereby the clinical symptom is non-specific and similar to that of a peptic ulcer. The diagnosis af gastric tuberculosis is based on either positive histological or bacteriological study. Submucasal tumors resembling gastric tuberculosis has been reported extremely rare in incidence. In this study we report a case of a young woman admitted with intermittent abdominal pain due to gastric tuberculosis presenting as submucosal tumor in the greater curvature of the lower body. After gastric resection, a histological examination revealed chronic granulomatous inflammation with caseation necrosis which is consistent with tuberculosis. There was no evidence of the tuberculous lesion anywhere else. The patient was put on antituberculosis medications. The patient's follow-up observation in the clinic was uneventful.
Subject(s)
Female , Humans , Abdominal Pain , Diagnosis , Follow-Up Studies , Incidence , Inflammation , Necrosis , Peptic Ulcer , Rare Diseases , Tuberculosis , UlcerABSTRACT
Gastric tuberculosis is a rare disease. It usually occurs secondarily to another lesions and mainly in the lungs. Only a few cases of primary gastric tuberculosis have been reported in the literature. Most commonly, gastric tuberculosis lesion locates in the lesser curvature side of the antrum. Therefore the clinical picture is similar to the peptic ulcer. A 24-year-old women visited to the Inha university hospital complaining of vomiting and epigastric discomfort. Gastrofiberscopy showed multiple polypoid mass around the pylorus with stenotic pyloric channel. Subtotal gastrectomy was performed and histologic examination revealed chronic granulomatous inflammation with caseation necrosis. That is compatible with tuberculosis. The patient was taken antituberculosis medication without complication. So we report the case of pyloric obstruction due to gastric tuberculosis with review of the literature.
Subject(s)
Female , Humans , Young Adult , Gastrectomy , Inflammation , Lung , Necrosis , Peptic Ulcer , Pyloric Stenosis , Pylorus , Rare Diseases , Tuberculosis , VomitingABSTRACT
Gastric tuberculosis is a rare disease and the diagnoeis of gastric tuberculosis is based on either positive histological or bacteriological study. We experienced a case of gastric tuberculosis with pleural effuaion in 59 year-old woman, diagnosed by the histological study of the endoscopic biopsy specimen. Follow up endoscopic finding revealed marked improvement of gastric lesion after anti-tubercadoua medication. We reported the case with review of literature.