Tuberculous gastric perforation: report of a case.
A 21-year-old woman presented with a 2-day history of acute abdominal pain. Contrast-enhanced computed tomography (CT) showed a perforation in the lesser curve of the stomach. The patient suffered a bout of hematemesis, following which an endoscopy showed a bleeding blood vessel at the edge of the perforation. We performed an emergency distal gastrectomy, including the ulcer site. Histopathological examination revealed tuberculous granulation tissue and acid-fast bacilli in the ulcer. The patient was given antituberculosis therapy (ATT) postoperatively, and was well when last seen 1 year 5 months after surgery. We analyzed the clinical data of five cases of tuberculous gastric perforation (TGP), reported between 1948 and 2003, including our patient. The patients ranged in age from 21 to 45 years, with a mean age of 36.8 years (SD +/- 10.21), and a male to female ratio of 3 : 2. The diagnosis was confirmed by surgery or autopsy. Abdominal lymphadenopathy was present in all patients. Gastrectomy was performed in four patients, and two were given ATT. All four patients in the previous reports died of their disease.
Sharma
Deborshi
D
Department of Surgery, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi 110095, India.
Gupta
Arun
A
Jain
Bhupendra Kumar
BK
Agrawal
Vivek
V
Dargan
Puneet
P
Upreti
Lalendra
L
Arora
Vinod
V
D015746:Abdominal Pain / Q000209:etiology; D000328:Adult; D000995:Antitubercular Agents / Q000627:therapeutic use; D005260:Female; D005743:Gastrectomy; D006396:Hematemesis / Q000209:etiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010439:Peptic Ulcer Perforation / Q000209:etiology* / Q000382:microbiology / Q000601:surgery; D013272:Stomach Diseases / Q000209:etiology / Q000382:microbiology* / Q000601:surgery*; D013276:Stomach Ulcer / Q000209:etiology / Q000382:microbiology* / Q000601:surgery*; D016896:Treatment Outcome; D014385:Tuberculosis, Gastrointestinal / Q000150:complications*
D000995:Antitubercular Agents