Case Report
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World J Gastrointest Endosc. Jan 16, 2011; 3(1): 16-19
Published online Jan 16, 2011. doi: 10.4253/wjge.v3.i1.16
Duodenal tuberculosis presenting as gastric outlet obstruction: A case report
Haydee Buluran Flores, Felix Zano, Ena Lyn Ang, Norberto Estanislao
Haydee Buluran Flores, Felix Zano, Ena Lyn Ang, Norberto Estanislao, Philippine General Hospital, Manila City 1000, Philippines
Author contributions: Flores HB wrote the manuscript and contributed to the literature search; Zano F supervised the manuscript writing; and Ang EL and Estanislao N contributed to the literature search and editing the manuscript.
Correspondence to: Haydee Buluran Flores, MD, Gastrointestinal Clinic, Philippine General Hospital, Taft Avenue, Manila City 1000, Philippines. wishbonemydog@yahoo.com
Telephone: +63-2-9228604530 Fax: +63-2-5672983
Received: February 9, 2010
Revised: December 13, 2010
Accepted: December 20, 2010
Published online: January 16, 2011
Abstract

Gastric outlet obstruction is commonly associated with malignancies and peptic ulcer disease. However, when no malignancy is seen and the patient is non-responsive to conventional peptic ulcer treatment, other etiologies need to be explored. We report a case of gastric outlet obstruction due to duodenal tuberculosis. The patient is a 31 year old male who presented with 1 year history of recurrent epigastric pain and an acute episode of vomiting. Endoscopy revealed duodenal stricture. Computed tomography scan showed pyloroantral thickening. The patient was referred to the surgery service and underwent an exploratory laparotomy and gastrojejunostomy. A duodenal mass and calcified lymph nodes were noted on exploration and biopsy revealed a tuberculous origin. The patient was started on anti-tuberculosis medications and had improved on discharge. Gastroduodenal tuberculosis is rare and pyloric stenosis resulting from tuberculosis is even rarer. This, however, should be considered in patients who come from areas where the disease is endemic.

Keywords: Duodenal tuberculosis; Tuberculosis; Gastric outlet obstruction; Duodenal stricture