Tuberculous Gastric Perforation: Report of a Case

Abstract

A 21-year-old woman presented with a 2-day history of acute abdominal pain. Contrast-enhanced computed tomography (CT) showed a perforation in the lesser curve of the stomach. The patient suffered a bout of hematemesis, following which an endoscopy showed a bleeding blood vessel at the edge of the perforation. We performed an emergency distal gastrectomy, including the ulcer site. Histopathological examination revealed tuberculous granulation tissue and acid-fast bacilli in the ulcer. The patient was given antituberculosis therapy (ATT) postoperatively, and was well when last seen 1 year 5 months after surgery. We analyzed the clinical data of five cases of tuberculous gastric perforation (TGP), reported between 1948 and 2003, including our patient. The patients ranged in age from 21 to 45 years, with a mean age of 36.8 years (SD +/- 10.21), and a male to female ratio of 3 : 2. The diagnosis was confirmed by surgery or autopsy. Abdominal lymphadenopathy was present in all patients. Gastrectomy was performed in four patients, and two were given ATT. All four patients in the previous reports died of their disease.

A Case of Splenic Tuberculosis Forming a Gastro-splenic Fistula

“…However, the lung lesion that simultaneously presented with splenic lesion disappeared after antituberculous treatment, leading to our suspecting pulmonary Gastrointestinal perforation and fistula caused by tuberculosis are rare, and can cause serious complication than obstruction. [6][7][8] However, the fistula that occurred in our patient did not result in serious complications because it was contiguously formed between the posterior wall of stomach and the splenic hilum. Since creamy yellowish exudate was discharged through the fistula, biopsies were performed through the tract, and splenic tuberculosis was diagnosed.…”

“…5 Gastrointestinal perforation and fistula is a rare, severe complication that can occur in patients with gastric tuberculosis. [6][7][8] There are no case reports available on the main manifestation of gastro-splenic fistula formation caused by splenic tuberculosis in an immunocompetent patient. Here, we report a case of secondary splenic tuberculosis that formed a gastro-splenic fistula in a 61-year-old man.…”

Clinicopathological Profile of Gastrointestinal Tuberculosis Patie NTS at a Tertiary Care Hospital

“…6 It can affect gastrointestinal, lymphatic and pancreaticobiliary system. 7 Most of the cases of Gastrointestinal Tuberculosis (GITB) are due to M. tuberculosis. M. bovis earlier accounted for a substantial number of cases worldwide, is now less frequently encountered due to widespread pasteurization of milk.…”

Case of bronchoesophageal fistula with gastric perforation due to multidrug-resistant tuberculosis

“…Tuberculous gastric perforation is a rare presentation of gastric tuberculosis (TB) with six previous cases reported in the literature [1,2] . However, to the best of our knowledge, there are no previous reports of gastric perforation due to multidrug-resistant TB (MDR-TB).…”

“…This kind of presentation is seen in approximately 80% of cases, with ulcers ranging from a few millimeters to as large as 20 cm, and manifests as non-specific chronic abdominal pain [22] . Tubercular gastric ulcers usually perforate or bleed because of their superficial location and associated endarteritis [1] . Patients with complications, such as pyloric mass, stenosis, bleeding, or perforation, require surgery [1] .…”