A rare cause of duodenal stricture.
The authors report the case of a 62-year-old lady who had never lived overseas and who presented with symptoms of gastric outflow obstruction with weight loss. Endoscopic investigation demonstrated a tight, impassable stricture in the second part of the duodenum, with CT demonstrating a mass and surrounding lymphadenopathy. Extrinsic compression at this site in UK residents in late middle age usually heralds a diagnosis of pancreatic malignancy. In this case, investigation by endoscopic ultrasound with sampling of an otherwise inaccessible lymph node to obtain 'micro biopsies' by fine needle aspiration allowed a diagnosis of duodenal tuberculosis. The patient has responded to appropriate antibiotic therapy and is now well.
Addenbrooke's hospital, Cambridge, UK. hal-hilou@doctors.org.uk
Hossam
H
Al-Hilou
Nicholas
N
Carroll
Asif
A
Jah
Susan
S
Davies
Miles
M
Parkes
D003251:Constriction, Pathologic; D004378:Duodenal Diseases / Q000150:complications* / Q000382:microbiology*; D004380:Duodenal Obstruction / Q000209:etiology*; D005260:Female; D006801:Humans; D008875:Middle Aged; D014385:Tuberculosis, Gastrointestinal / Q000150:complications*