Primary gastric tuberculosis mimicking a submucosal tumor

Sharma, Vishal; Gunjan, Deepak; Chhabra, Puneet; Sharma, Ravi; Bhasin, Deepak K.

doi:10.4103/0976-5042.165723

Cited by 8 publications

(6 citation statements)

References 11 publications

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“…Endoscopic biopsy has a poor yield even in ulcerated lesions and endoscopic biopsy rarely reveals granulomas because of the predominantly submucosal location of these lesions and the failure of routine endoscopic biopsies to include the submucosa [ 17 ]. The diagnosis of duodenal TB is usually made after surgical intervention (exploratory laparotomy) and it is very rarely made preoperatively [ 25 ]; however, Sharma et al reported that endoscopic ultrasonography (EUS) is an excellent modality for characterizing the lesion, as well as obtaining a sample for cytological confirmation of the diagnosis [ 26 ]. Multiple intraoperative fine-needle aspiration cytology (FNAC) may be taken from the diseased portion of the duodenum to establish the histopathological diagnosis if not established by any other means [ 7 ].…”

Section: Discussionmentioning

confidence: 99%

Primary gastric tuberculosis presenting as gastric outlet obstruction: a case report and review of the literature

Arabi¹,

Musaad²,

Ahmed³

et al. 2015

J Med Case Reports

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IntroductionTuberculosis is a major health problem worldwide. Sudan has high burden of tuberculosis (TB) with a prevalence of 209 cases per 100,000 of the population and it is commonly presented with pulmonary disease but involvement of the gastrointestinal tract is not uncommon. Abdominal tuberculosis comprises about 1–3 % of all cases of tuberculosis and about 12% of extrapulmonary tuberculosis. It involves the ileocecal region, but involvement of stomach and duodenum are rare sites. Here we present an unusual case of gastric outlet obstruction due to gastric tuberculosis.Case presentationA 54-year-old Sudanese man presented with a non-bile stain persistent projectile vomiting, and epigastric pain for two years associated with marked loss of weight. There is no fever or cough. He was on antacid, physical examination showed BMI 18 and stable vital signs. He was not pale or jaundiced, there was no cervical lymphadenopathy and chest was clear. Abdominal examination was normal apart of positive succussion splash. The results of haematological tests were normal, ESR was 30 mm/hr, hepatitis B, C and HIV were negative. Upper gastrointestinal endoscopy showed that the stomach was full of fluid and food particles and ulcerated mass in the pylorus extended to the proximal part of the duodenum with severe narrowing of the pylorus. The lesion biopsied and the result revealed active inflammatory cells, cryptitis and multiple lymphoid follicles, no malignancy seen. Sonographic test showed hypodense pyloric mass, enlarged para-aortic and mesenteric lymph nodes and mild pelvic ascites. A computed tomography scan of the abdomen and pelvis showed antral hypodense lesions multiple mesenteric lymphadenopathies peritoneal thickening and ascites. Chest X-ray was normal. Intra-operative findings were dilated stomach and pylorus mass with multiple mesenteric lymph nodes, peritoneal and omental seedlings all over with small nodules on the surface of the liver, gastro-jejunostomy was done. Histopathology confirmed the diagnosis of abdominal tuberculosis. Postoperative event was uneventful. Patient received anti-tuberculous.ConclusionsHere we presented an unusual case of gastric outlet obstruction due to primary gastric tuberculosis, patient underwent surgery to relief his symptoms and received anti-tuberculous.

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Section: Discussionmentioning

confidence: 99%

Primary gastric tuberculosis presenting as gastric outlet obstruction: a case report and review of the literature

Arabi¹,

Musaad²,

Ahmed³

et al. 2015

J Med Case Reports

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“…For suspected gastric tuberculosis, multiple deep biopsies, repeated biopsies, EUS-guided fine-needle aspiration or EUS-guided fine-needle biopsy (EUS-FNA or EUS-FNB) [13] should be performed. The first two patients underwent repeated deep excavation biopsy along the central erosion of the lesions and received a final diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Gastric tuberculosis mimicking submucosal tumor: a case series

et al. 2020

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Background: Gastric tuberculosis mimicking submucosal tumors is extremely rare and often misdiagnosed. Case presentation: Three cases of gastric tuberculosis mimicking submucosal tumors were identified among patients admitted to local county hospitals because of upper abdominal discomfort and pain, with gastroscopy showing gastric submucosal tumors. The patients were admitted to our hospital for endoscopic ultrasonography (EUS). As EUS revealed evidence of tuberculosis for the first two patients, we first considered gastric tuberculosis. However, because of atypical characteristics of the miniature ultrasonic probe and EUS, the lesion in the third patient was misdiagnosed as a stromal tumor, and the patient underwent endoscopic submucosal dissection (ESD), and intraoperative characteristics and postoperative pathology confirmed the lesion to be tuberculosis. Conclusions: EUS is of great value in the diagnosis of gastric tuberculosis, especially gastric tuberculosis mimicking submucosal tumors. Here, we summarize some significant characteristics of gastric tuberculosis by EUS, which will be of substantial value to clinical work.

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“…In a report of 10 patients of whom 9 underwent dilatation, there was like lymph nodes which may cause luminal narrowing or bulge with normal overlying mucosa. 1,7 The availability of endoscopic ultrasound provides a modality to access and sample such lesions. 7 To conclude, endoscopic diagnosis is feasible in duodenal tuberculosis and patients respond well to the standard ATT while some patients may need dilatation of GOO.…”

Section: Discussionmentioning

confidence: 99%