Primary Gastric Tuberculosis Presenting as Non-Healing Ulcer and Mimicking Crohn's Disease

Ishii, Naoki; Furukawa, Keiichi; Itoh, Toshiyuki; Fujita, Yoshiyuki

doi:10.2169/internalmedicine.50.4634

Cited by 8 publications

(8 citation statements)

References 8 publications

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“…However, even if a pathological biopsy is performed under a gastroscope, the pathological result of lesions may be non-speci c in ammation [14]. Ishii et al once reported that patients with primary gastric tuberculosis showed negative acid-fast bacilli staining but were effective for empirical ATT [15]. Tuberculous granuloma is more likely to produce negative results, which may be related to the deeper location of tuberculous granuloma [16].…”

Section: Discussionmentioning

confidence: 99%

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

Liao

Zuo

et al. 2020

Preprint

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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.

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Section: Discussionmentioning

confidence: 99%

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

Liao

Zuo

et al. 2020

Preprint

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“…In fact, our patient showed negative acid-fast bacilli staining. Ishii et al have demonstrated a patient with primary gastric TB showing negative acid-fast bacilli staining, but the patient responded to empiric ATT effectively [9]. Baylan et al have also shown that a patients presented negative acid-fast bacilli staining and negative bacterial culture of the biopsy specimen, whereas had positive PCR for M. TB [20].…”

Section: Discussionmentioning

confidence: 99%

“…Two cases were gastric TB with concomitant cancer [18, 24]. PCR was commonly used to diagnose gastric TB since 2011 (Table 1) [8, 9, 15–18]. Most cases presented caseating granuloma in endoscopic biopsy specimens or surgical specimens (Table 1).…”

Section: Case Presentationmentioning

confidence: 99%

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Critical role of molecular test in early diagnosis of gastric tuberculosis: a rare case report and review of literature

Yin

Xie

2019

BMC Infect Dis

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Backgroud Early diagnosis of gastric tuberculosis is often challenging because the disease is very rare and its clinical manifestation is nonspecific and misleading. To raise the awareness and emphasize early diagnosis of gastric tuberculosis, we present a case of gastric tuberculosis secondary to pleural and pulmonary tuberculosis. Case presentation A 26-year-old woman complained gastric pain for 1 month but showed no other symptoms, who had no previous exposure to tuberculosis.Gastric stromal tumor was originally suspected. However, the pathology of her gastroscopic biopsy of the gastric lesion showed granulomatous lesions and caseating necrosis. Gene sequencing of the biopsy specimen identified deoxyribonucleic acid fragment of Mycobacterium tuberculosis . Chest computed tomography scan revealed nodular shadows in the lesser curvature soft tissue of the stomach, patchy densities and calcified nodular shadows in the upper right lung, bilateral pleural thickening, and calcified pleural nodules. Thus, the diagnosis was gastric tuberculosis secondary to pulmonary and pleural tuberculosis. The patient was hospitalized and treated with the antituberculosis therapy for 1 week. After discharged from the hospital, the patient continued routine antituberculosis therapy for 18 months and was follow-up was normal.Literature search found 22 cases of gastric tuberculosis reported from 2000 to 2016. Review of the 22 cases suggested that polymerase chain reaction has been increasingly used in the recent years in addition to the conventional histopathological and bacteriological approaches. Conclusion Clinical presentation of gastric tuberculosis is not specific.When granuloma or caseation is detected on biopsy in patients who are suspected of having gastric malignancy or acid peptic diseases, polymerase chain reaction for Mycobacterium tuberculosis could be used as an available and sensitive diagnostic test in addition to pathology, acid-fast bacilli smear staining and culture.

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“…3 The presentation of these patients varies. Patients may present with haematemesis, 4 non-healing chronic ulcer 5 , mimicking malignancy 6 , gastric perforation 7 and gastric outlet obstruction. 8 Primary isolated gastric TB in absence of pulmonary TB in immune competent host is rare.…”

Section: Introductionmentioning

confidence: 99%

Isolated Gastro-Duodenal Tuberculosis Mimics Peptic Ulcer Disease in a Young Female

Hasan¹,

Mondal²,

Rashid³

et al. 2019

J Enam Med Col

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Intestinal tuberculosis (TB) most commonly affects ileo-caecal region. Isolated gastric and duodenal involvement without pulmonary infection is rare. The presentation of these patients varies. Patients may present with haematemesis, non-healing chronic ulcer, mimicking malignancy, gastric perforation and gastric outlet obstruction. High degree of suspicion is needed for early diagnosis of gastro-duodenal TB. A young female patient who was being treated as a case of nonhealing chronic ulcer was referred for treatment. Histopathological examination of endoscopic biopsy specimen of the patient showed presence of granulomas composed of epitheloid cells and Langhan’s giant cells with caseation with no evidence of tuberculosis at pulmonary or other body sites. After anti-tubercular chemotherapy there was resolution of symptoms and healing of ulcers. This case of isolated gastro-duodenal TB is reported for its rarity. J Enam Med Col 2019; 9(3): 189-192

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Primary Gastric Tuberculosis Presenting as Non-Healing Ulcer and Mimicking Crohn's Disease

Cited by 8 publications

References 8 publications

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

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

Critical role of molecular test in early diagnosis of gastric tuberculosis: a rare case report and review of literature

Isolated Gastro-Duodenal Tuberculosis Mimics Peptic Ulcer Disease in a Young Female

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