Duodenal tuberculosis: A review of the clinicopathologic features and management of twelve cases

Abstract

A retrospective analysis of twelve cases of duodenal tuberculosis is presented herein. The average age of the patients was 31.4 years with a male to female ratio of 2:1. The presenting complaints were duodenal obstruction in six patients and subacute intestinal obstruction in three. None of the patients had associated pulmonary tuberculosis. Eight patients had isolated duodenal tuberculosis, two of whom were successfully treated with antitubercular drugs. In four patients, the diagnosis was established at laparotomy by the presence of tubercles over the duodenum. Five patients required a bypass procedure for obstruction caused by the duodenal tuberculosis and one patient was operated on for uncontrollable bleeding from a tubercular duodenal ulcer. All patients remained symptom free after treatment, whether medical or surgical. Thus, in areas where tuberculosis is endemic, even in the absence of pulmonary tuberculosis, duodenal tuberculosis should be suspected in patients with upper gastrointestinal obstruction or in patients with peptic ulcer like symptoms not responding to medical therapy.

Gastrointestinal tuberculosis

“…Symptoms persisting for 7 to 10 years before diagnosis have been reported [10,11]; however, it is unclear in these cases if the extended course was due to a delay in presentation or in diagnosis. Other rare forms of presentation include dysphagia from esophageal tuberculosis [24], gastrointestinal bleeding caused by pancreatic tuberculosis eroding into the duodenum [25], hemobilia and esophageal varices secondary to hepatic involvement [26,27], tuberculous gastric [28] or duodenal ulceration [29], and fistulization from the esophagus [30] or duodenum [31] to the aorta.…”

A rare cause of duodenal stricture

“…The GI tract is the sixth most common extra pulmonary site 2. TB of the GI tract most often affects the ileocaecal region 3 4. Duodenal involvement accounts for only 2.3% of tuberculous enteritis 3.…”

Tuberculous Duodenal Stenosis: Report of Two Cases

“…Tuberculosis of the gastrointestinal tract most often affects the ileocecal region [3, 4]. Duodenal involvement accounts for only 2.3% of tuberculous enteritis [3].…”

“…Surgical intervention is indicated in such cases of duodenal tuberculosis because the obstruction occurs as a result of stricture formation [4, 8]. The surgical treatement includes either resection of the affected part or a bypass procedure [9].…”