Primary gastroduodenal tuberculosis presenting as gastric outlet obstruction: A case report and review of literature

Figure 1 Oral and intravenous contrast-enhanced thoraco-abdominal computed tomography scans. A: It demonstrates gastric distension; B: It accompanied by multiple mesenteric lymphadenopathies; C: Duodenal wall thickening and nearly complete obstruction in the second part of the duodenum; D: Thoracic computed tomography findings indicated normalcy, with no active pulmonary tuberculosis or sequelae observed.

Figure 2 Intraoperative finding. A-C: An intense inflammatory mass causing duodenal obstruction alongside multiple pathologic lymph nodes observed in the mesenteric and paraduodenal regions; D: Resected distal gastric and dissected lymph nodes.

Figure 3 Histopathology. A: Granulomatous inflammation and giant cells on the serosal surface; B: Lymph node parenchyma with effacement of multiple large tuberculoid necrotizing granuloma; C: Lymph node parenchyma with effacement of large tuberculoid necrotizing granuloma (thick arrows) epithelioid histiocytes (thin arrows) peripheral lymphocytes (triangles); D: Lymph node with tuberculoid necrotizing granuloma (thick arrows) and Langerhans giant cells (thin arrows) and peripheral lymphocytes (triangles).