Disseminated Tuberculosis Presenting as Gastric Outlet Obstruction

Abstract

A 12-year-old female had a three-year history of fever, non-bilious vomiting and abdominal pain. Upper gastrointestinal series showed a filling defect at the duodenum. Esophagogastroduodenoscopy exhibited circumferentialmass extending from the duodenal bulb to the 2nd part of the duodenum which on histology disclosed chronicgranulomatous inflammation. Chest X-ray suggested miliary tuberculosis; endotracheal tube aspirate was PCRpositive for Mycobacterium tuberculosis. Patient was diagnosed as disseminated tuberculosis of the duodenumand lungs. Quadruple anti-tuberculosis medication was started but patient succumbed to nosocomial sepsis.