Primary gastric tuberculosis--report of 5 cases.

Deepak N Amarapurkar,Anjali D Amarapurkar,Nikhil D Patel

doi:10.1186/1471-230x-3-6

Abstract

BackgroundGastric tuberculosis is rare, and usually associated with pulmonary tuberculosis or an immunodeficient state. Here, we report five cases of gastric tuberculosis in immunocompetent patients without evidence of pulmonary involvement.Case presentationThree patients presented with gastric outlet obstruction that required surgery to relieve the obstruction as well as to confirm the diagnosis. The remaining two had involvement of gastroesophageal junction. All of them responded well to standard antitubercular treatment.ConclusionThough gastric tuberculosis is rare, it should be considered a possibility when patients present with gastric outlet obstruction or with endoscopic evidence of diffuse chronic inflammatory activity, particularly in areas endemic for tuberculosis.

Highlights

BackgroundTuberculosis of stomach whether primary or secondary infection is not common. [1,2] It is usually associated with pulmonary tuberculosis or with immunodeficiency state. [3] Clinically it resembles peptic ulcer disease or malignancy. [4] we report 5 cases of gastric tuberculosis in immunocompetent patients without evidence of pulmonary involvement
Gastric tuberculosis is rare, and usually associated with pulmonary tuberculosis or an immunodeficient state
Though gastric tuberculosis is rare, it should be considered a possibility when patients present with gastric outlet obstruction or with endoscopic evidence of diffuse chronic inflammatory activity, in areas endemic for tuberculosis

Summary

Background

Tuberculosis of stomach whether primary or secondary infection is not common. [1,2] It is usually associated with pulmonary tuberculosis or with immunodeficiency state. [3] Clinically it resembles peptic ulcer disease or malignancy. [4] we report 5 cases of gastric tuberculosis in immunocompetent patients without evidence of pulmonary involvement. Histopathology of the lymph node revealed caseating granuloma He was put on ATT regimen of (HERZ) 2(HR) 7 during which, he gained weight of 12 kgs and became symptom free. Case 3 A 23 years female presented with epigastric pain, vomiting and loss of weight for last 6 months Her upper GI endoscopy was suggestive of narrowed antrum and gastric outlet obstruction. A lymph node mass was seen obstructing pyloroduodenal region which on histology was suggestive of caseating granuloma with presence of acid fast bacilli She received ATT that is (HERZ) 2(HR) 7 for 1 year and was symptom free. Endoscopic biopsy showed multiple caseating granulomas suggestive of tuberculosis He was put on ATT regimen of (HERZ) 2(HR) 7 and became symptom free

Discussion

Conclusion