A Case of Duodenal Tuberculosis Associated with Hematemesis

Jung, Hee Jin; Song, Hwon Taig; Song, Chi Wook; Lee, Sang Woo; Kim, Chang Duck; Ryu, Ho Sang; Hyun, Jin Hai

Abstract

Despite the marked decreased frequency of tuberculosis in the world by advent of effective chemotherapy, gastrointestinal tuberculosis is considered to be relativeiy frequent in developing countries. Tuberculosis of the duodenum is rare, little reported in the literature. The prevalenoe rates in reports dealing with necropsy observations in patient with pulmonary tuberculosis range from 0.36%-2.3%. Definitive diagnosis will require endoscopic or surgical biopsy because of inconsistent clinical findings, Recently, we experienced a case of duodenal tuberculosis with massive UGI bleeding, masquering as a duodenal ulcer bleeding, and diagnostic confirmation was attained by histologic findings of endoscpic biopsy. A 65-year-old woman was admitted with 3 months history of epigastric discomfort, 1 day history of hematemesis and melena. Urgent endoscopy revealed active bleeding from a large ulcer causing obstruction of the 2 nd portion of duodenum and endoscopic electrocoagulation was performed with success. After a reasonable medical trial, follow-up endascopic examinations of lesion showed no response. So, endoscopic biopsies was done and histopathology revealed multiple granuloma with central necrosis.