Tubercular lymphadenopathy with duodenal fistula
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 generalize...
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| Format: | Article |
| Language: | English |
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Thieme Medical and Scientific Publishers Pvt. Ltd.
2016-04-01
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| Series: | Journal of Digestive Endoscopy |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.4103/0976-5042.189157 |
| _version_ | 1818847490820014080 |
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| author | Mukesh Nasa Zubin Sharma Neeraj Saraf Rajesh Puri |
| author_facet | Mukesh Nasa Zubin Sharma Neeraj Saraf Rajesh Puri |
| author_sort | Mukesh Nasa |
| collection | DOAJ |
| description | 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. |
| first_indexed | 2024-12-19T06:02:17Z |
| format | Article |
| id | doaj.art-e30416616c614076982e8a4abae870f8 |
| institution | Directory Open Access Journal |
| issn | 0976-5042 0976-5050 |
| language | English |
| last_indexed | 2024-12-19T06:02:17Z |
| publishDate | 2016-04-01 |
| publisher | Thieme Medical and Scientific Publishers Pvt. Ltd. |
| record_format | Article |
| series | Journal of Digestive Endoscopy |
| spelling | doaj.art-e30416616c614076982e8a4abae870f82022-12-21T20:33:16ZengThieme Medical and Scientific Publishers Pvt. Ltd.Journal of Digestive Endoscopy0976-50420976-50502016-04-01070207407610.4103/0976-5042.189157Tubercular lymphadenopathy with duodenal fistulaMukesh Nasa0Zubin Sharma1Neeraj Saraf2Rajesh Puri3Consultant, Institute of Digestive Disease and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, IndiaDNB Fellow, Institute of Digestive Disease and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, IndiaAssociate Director, Institute of Digestive Disease and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, IndiaDirector, Institute of Digestive Disease and Hepatobiliary Sciences, Medanta - The Medicity, Gurgaon, Haryana, IndiaTuberculosis, 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.http://www.thieme-connect.de/DOI/DOI?10.4103/0976-5042.189157duodenal tuberculosisendoscopic ultrasoundtubercular lymphadenopathy |
| spellingShingle | Mukesh Nasa Zubin Sharma Neeraj Saraf Rajesh Puri Tubercular lymphadenopathy with duodenal fistula Journal of Digestive Endoscopy duodenal tuberculosis endoscopic ultrasound tubercular lymphadenopathy |
| title | Tubercular lymphadenopathy with duodenal fistula |
| title_full | Tubercular lymphadenopathy with duodenal fistula |
| title_fullStr | Tubercular lymphadenopathy with duodenal fistula |
| title_full_unstemmed | Tubercular lymphadenopathy with duodenal fistula |
| title_short | Tubercular lymphadenopathy with duodenal fistula |
| title_sort | tubercular lymphadenopathy with duodenal fistula |
| topic | duodenal tuberculosis endoscopic ultrasound tubercular lymphadenopathy |
| url | http://www.thieme-connect.de/DOI/DOI?10.4103/0976-5042.189157 |
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