Duodenal tuberculosis; uncommon cause of gastric outlet obstruction

Abstract

© 2019, Japanese Society of Gastroenterology. Gastrointestinal tuberculosis manifesting as isolated duodenal involvement is uncommon. We present a case of 52 years old man with post-prandial abdominal pain, early satiety and weight loss. Upper endoscopy showed circumferential duodenal stricture adjacent to the ampulla with nodularity, erythema, and ulcerations of the overlying mucosa causing gastric outlet obstruction. Biopsy of duodenal stricture revealed chronic duodenitis and the patient was treated with acid suppression therapy. Endoscopic balloon dilation was also performed with no response. Abdominal computer tomography scan showed multiple enlarged abdominal lymph nodes and subsequent duodenal tissue culture was positive for Mycobacterium tuberculosis. His symptoms and duodenal stricture resolved completely after treatment with anti-tuberculous regimen.