Korean J Gastrointest Endosc.  2007 Nov;35(5):346-350.

Intestinal Tuberculosis with a Duodenal Fistula

• Park EB
• Jeen YT
• Ahn JH
• Suh SJ
• Lee SJ
• Park NS
• Keum B
• Seo YS
• Kim YS
• Chun HJ
• Lee HS
• Um SH
• Lee SW
• Choi JH
• Kim CD
• Ryu HS

Abstract

Intestinal tuberculosis is a common disease of extrapulmonary tuberculosis. A diagnosis of intestinal tuberculosis is difficult as the symptoms and laboratory findings are not specific for the disease. Intestinal tuberculosis may cause various complications, such as intestinal obstruction, intestinal perforation, intraabdominal abscess, intestinal hemorrhage and fistula formation. A duodenal fistula caused by tuberculosis is an especially rare condition. We experienced a case of intestinal tuberculosis with a duodenal fistula as a complication. The patient was a 25-year-old man that presented with weight loss and diarrhea. Esophagogastroduodenoscopy showed a deep ulcerative lesion on the third portion of the duodenum with a fistula opening. A histological finding revealed granulomatous inflammation with multinucleated giant cells. In addition, the result of a Tb PCR assay was positive. After two months of treatment with the appropriate medication, the symptoms improved and the fistula has closed completely. We report the case with a review of the literature.

Keyword

Tuberculosis; Intestinal tuberculosis; Duodenal fistula

MeSH Terms

Abscess
Adult
Diagnosis
Diarrhea
Duodenum
Endoscopy, Digestive System
Fistula*
Giant Cells
Hemorrhage
Humans
Inflammation
Intestinal Obstruction
Intestinal Perforation
Polymerase Chain Reaction
Tuberculosis*
Ulcer
Weight Loss