Isolated gastric tuberculosis of the cardia.
BACKGROUND
Isolated gastric tuberculosis is extremely rare, especially in the subcardiac region, where the low pH, high motility and absence of lymphoid tissue result in an unfavourable environment for the development of tuberculous lesions.


RESULTS
Here we present a case of isolated gastric tuberculosis in the gastric cardia with no evidence of pulmonary involvement. Our patient was a young man with vague gastrointestinal symptoms and no previous history of tuberculosis. His condition was first detected on upper endoscopy as a raised subcardiac ulcer similar in appearance to a submucosal tumour. An endoscopic forceps biopsy showed the presence of caseating granulomata and acid-fast bacilli. The lesion resolved completely with 12 months of oral anti-tuberculosis therapy.


CONCLUSIONS
This case illustrates the need for a high index of suspicion in order to diagnose this rare condition, as it can present in patients with no particular risk factors or symptoms. Once diagnosed, a complete cure can often be achieved with a course of oral anti-tuberculosis medication, with surgery being reserved for severely symptomatic or refractory lesions.
Lin
O S
OS
Division of Gastroenterology, ChangHua Christian Medical Center, Taiwan.
Wu
S S
SS
Yeh
K T
KT
Soon
M S
MS
D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D002299:Cardia; D004359:Drug Therapy, Combination; D006801:Humans; D008297:Male; D012307:Risk Factors; D013272:Stomach Diseases / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology; D014385:Tuberculosis, Gastrointestinal / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology
D000995:Antitubercular Agents