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CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2014; 05(03): 121-125
DOI: 10.4103/0976-5042.147499
Case Report
Society of Gastrointestinal Endoscopy of India

A case series of gastric outlet obstruction secondary to tuberculosis: New diagnostic and treatment paradigm

Rinkesh Kumar Bansal
Departments of Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India
,
Piyush Ranjan
Departments of Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India
,
Mandhir Kumar
Departments of Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India
,
Munish Sachdeva
Departments of Gastroenterology, Sir Ganga Ram Hospital, New Delhi, India
,
Pooja Bakshi
1   Department of Gastroenterology Cytopthology, Sir Ganga Ram Hospital, New Delhi, India
› Author Affiliations
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Publication History

Publication Date:
26 September 2019 (online)

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Abstract

Tuberculosis can involve any part of gastrointestinal tract. Gastro-duodenal involvement in tuberculosis is rare. We report four cases of gastric outlet obstruction due to tuberculosis. In all of these patients obstruction was due to extra-luminal compression from lymph-nodes. Clinical presentation was with epigastric pain and recurrent vomiting. Upper GI endoscopy revealed duodenal stricture without any active ulcer or mass. Computed tomography scan showed duodenal thickening along with abdominal lymph nodes. Diagnosis was confirmed with EUS guided FNAC. Antral dilatation using CRE can be used as first treatment option for obstruction in these patients. Patients non responsive to dilatation may require surgery.

Key words

Controlled radial expansion dilatation of benign gastric outlet obstruction - gastric outlet obstruction - gastro-duodenal tuberculosis
 

  • References

  • 1 Kochhar R, Kochhar S. Endoscopic balloon dilation for benign gastric outlet obstruction in adults. World J Gastrointest Endosc 2010;2:29-35.
  • 2 Gupta P, Guleria S, Mathur SR, Ahuja V. Gastroduodenal tuberculosis: A rare cause of gastric outlet obstruction. Surg J 2010;5:36-9.
  • 3 Tromba JL, Inglese R, Rieders B, Todaro R. Primary gastric tuberculosis presenting as pyloric outlet obstruction. Am J Gastroenterol 1991;86:1820-2.
  • 4 Flores HB, Zano F, Ang EL, Estanislao N. Duodenal tuberculosis presenting as gastric outlet obstruction: A case report. World J Gastrointest Endosc 2011;3:16-9.
  • 5 Rao YG, Pande GK, Sahni P, Chattopadhyay TK. Gastroduodenal tuberculosis management guidelines, based on a large experience and a review of the literature. Can J Surg 2004;47:364-8.
  • 6 Chazan BI, Aitchison JD. Gastric tuberculosis. Br Med J 1960;2:1288-90.
  • 7 Tandon H. The pathology of intestinal tuberculosis. Trop Gastroenterol 1981;2:77-93.
  • 8 Vij JC, Ramesh GN, Choudhary V, Malhotra V. Endoscopic balloon dilation of tuberculous duodenal strictures. Gastrointest Endosc 1992;38:510-1.
  • 9 Kuwada SK, Alexander GL. Long-term outcome of endoscopic dilation of nonmalignant pyloric stenosis. Gastrointest Endosc 1995;41:15-7.
  • 10 Kochhar R, Sethy PK, Nagi B, Wig JD. Endoscopic balloon dilatation of benign gastric outlet obstruction. J Gastroenterol Hepatol 2004;19:418-22.