Download PDF
CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2016; 07(02): 074-076
DOI: 10.4103/0976-5042.189157
Case Report
Journal of Digestive Endoscopy

Tubercular lymphadenopathy with duodenal fistula

Mukesh Nasa
Consultant, Institute of Digestive Disease and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, India
,
Zubin Sharma
1   DNB Fellow, Institute of Digestive Disease and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, India
,
Neeraj Saraf
2   Associate Director, Institute of Digestive Disease and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, India
,
Rajesh Puri
3   Director, Institute of Digestive Disease and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, India
› Author Affiliations
Further Information

Publication History

Publication Date:
26 September 2019 (online)

Also available at
  PDF Download Permissions and Reprints

Abstract

Tuberculosis, both pulmonary and extrapulmonary, is one of the leading causes of significant morbidity and mortality in developing countries. A 29-year-old chronic alcoholic patient presented to gastroenterology outpatient department with complaints of decreased appetite, weight loss, and generalized weakness. On endoscopy, the second part of duodenum appeared edematous with some luminal compromise. There was also presence of an opening in the inferolateral wall of the second part of duodenum, through which milky white caseous material was coming out. Computed tomography demonstrated large conglomerate of paraduodenal, celiac, para-aortic, peripancreatic, and retrocaval nodes with central necrosis. Endoscopic ultrasound showed hypoechoic lymph nodes in paraduodenal, parapancreatic, and celiac axis. Fine needle aspiration cytology showed epithelioid granuloma with Langerhans giant cells suggestive of granulomatous lymphadenitis of tubercular etiology. Tubercular lymphadenopathy eroding into duodenum has been very rarely reported in literature. This case reports the rare possibility of extrinsic tubercular lymphadenopathy eroding into duodenum.

Key words

Duodenal tuberculosis - endoscopic ultrasound - tubercular lymphadenopathy
 

  • References

  • 1 Sharma MP, Bhatia V. Abdominal tuberculosis. Indian J Med Res 2004;120:305-15.
  • 2 Bhansali SK. Abdominal tuberculosis. Experiences with 300 cases. Am J Gastroenterol 1977;67:324-37.
  • 3 Bhatti A, Hussain M, Kumar D, Samo KA. Duodenal tuberculosis. J Coll Physicians Surg Pak 2012;22:111-2.
  • 4 Puri AS, Sachdeva S, Banka A, Sakhuja P. Tuberculosis of the duodenum. Indian J Tuberc 2013;60:83-8.
  • 5 Kwon DY, Park HW, Seo SH, Jang BK, Hwang JY, Lee JM, et al. A Case of Duodenal Fistula Caused by Intestinal Tuberculosis, Korean Journal of Gastrointestinal Endoscopy 2004;28:131-5.