Primary gastroduodenal tuberculosis complicated with acute pancreatitis: a rare case report and literature review
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(2020) 25:65 Li et al. Eur J Med Res https://doi.org/10.1186/s40001-020-00468-5
Open Access
CASE REPORT
Primary gastroduodenal tuberculosis complicated with acute pancreatitis: a rare case report and literature review Yuanhua Li, Suhuan Liao, Haijun Zuo, Wei Yang and Di Jiang*
Abstract Background: Tuberculosis (TB) is a major health problem worldwide. Even in highly prevalent countries, primary gastroduodenal tuberculosis is a rare manifestation of extrapulmonary tuberculosis. In recent years, as the incidence of tuberculosis has increased year by year, the occur of gastroduodenal tuberculosis has also increased. Endoscopy is an important tool for diagnosing gastroduodenal tuberculosis. The performance of gastroduodenal tuberculosis under endoscopy is often non-specific, which may imitate other benign or malignant gastroduodenal diseases. Diagnosis of gastroduodenal tuberculosis relies on a combination of endoscopy and guided biopsy. Case presentation: Here, we report a rare and interesting case of gastroduodenal tuberculosis with acute pancreatitis. The case initially mimicked gastroduodenal ulcers in morphology and appeared in a middle-aged person with normal immunity but with prolonged fever and abdominal pain. The disease was diagnosed through endoscopy and guided biopsy, and it responded well to antituberculosis drugs. Conclusions: Clinicians must remember that even in the absence of immunodeficiency, as in this case, tuberculosis can affect any part of the gastrointestinal tract. Keywords: Tuberculosis, Gastroduodenal tuberculosis, Endoscopy, Biopsy, Case report Introduction Tuberculosis remains a major public health problem, mainly affecting low- and middle-income countries, causing more than 1.5 million deaths each year [1]. Although the most common manifestation of tuberculosis is the lung, cases of extrapulmonary tuberculosis are not uncommon, but the stomach and duodenum are rare parts of tuberculosis [2, 3]. The unique characteristics of the stomach and duodenum such as the sterilizing properties of stomach acid, lack of lymphatic tissue, rapid emptying and intact mucosa, can protect organs from tuberculosis [4]. Gastroduodenal tuberculosis is usually the result of secondary spread of primary lung disease. *Correspondence: [email protected] Department of Gastroenterology, Tungwah Hospital of Sun Yat-Sen University, Dongguan, Guangdong, China
According to reports, the incidence of gastroduodenal tuberculosis is only 0.5%, of which primary gastroduodenal tuberculosis is even rarer [2, 3]. Due to the rarity of the disease, the clinical manifestations have no obvious specificity, and the auxiliary examination, especially under the gastroscopy, is not typical, so most of them are misdiagnosed, such as gastric ulcers, gastric cancer, and gastric submucosal tumors [5–7]. We introduce a case of primary gastroduodenal tuberculosis, and summarize the characteristics of gastroduodenal ulcer.
Case presentation A 41-year-old male patient was admitted to Tungwah Hospital of Sun Yat-Sen University on Apri
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