Primary pyloroduodenal tuberculosis presenting as gastric outlet obstruction. A case report

TL;DR

This case report describes a rare instance of gastric outlet obstruction caused by tuberculosis in a 31-year-old man, highlighting the need for TB to be considered in differential diagnoses in endemic areas.

Contribution

The paper presents a rare case of primary pyloroduodenal tuberculosis as a cause of gastric outlet obstruction in an adult.

Findings

Duodenal tuberculosis is a rare cause of gastric outlet obstruction in adults.

A high index of suspicion is needed to diagnose tuberculosis as a cause of gastric outlet obstruction in endemic regions.

Laparotomy was necessary for both diagnosis and relief of obstruction in this case.

Abstract

Gastric Outlet Obstruction (GOO) is a clinical syndrome due to mechanical obstruction of the gastric outlet near the antrum. The incidence of GOO is not known adequately; however, it is estimated that its incidence has declined in recent years as the incidence of peptic ulcer disease, which is the common cause of GOO, has been declining recently due to the use of proton pump inhibitor (PPI). The objective of this case report to highlight the importance of consideration of TB as a cause of GOO by affecting the duodenal wall and nearby lymph node enlargement.

The case was a 31-year-old man who presented to the surgical referral clinic with a complaint of non-projectile vomiting of ingested matter. The patient also had a significant amount of weight loss. Laparotomy was done and displayed multiple enlarged pyloric and duodenal lymph nodes with a thickened duodenal wall. The patient was discharged from the ward after one week of hospital stay. For diagnosing the disease and relieving obstruction, laparotomy is usually required.

Generally, gastric outlet obstruction is a common and early complication associated with duodenal ulcers. However, cases of gastric outlet obstruction caused by other factors are rare.

In a patient presented with symptoms and signs suggestive of GOO with symptom complex of TB (tuberculosis). Early identification and appropriate management can lead to improved outcomes for patients with this rare form of tuberculosis.

•Gastric Outlet Obstruction (GOO) is a clinical syndrome due to mechanical obstruction of the gastric outlet near the Antrum.•Duodenal tuberculosis is one of the rare causes of GOO.•It is rare to find a GOO in an adult caused by duodenal tuberculosis.•There should be a high index of suspicion to consider Tuberculosis as a differential diagnosis for GOO in endemic area

Gastric Outlet Obstruction (GOO) is a clinical syndrome due to mechanical obstruction of the gastric outlet near the Antrum.

Duodenal tuberculosis is one of the rare causes of GOO.

It is rare to find a GOO in an adult caused by duodenal tuberculosis.

There should be a high index of suspicion to consider Tuberculosis as a differential diagnosis for GOO in endemic area

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