Duodenal tuberculosis - 16/08/11
| Commentary TB has been identified in prehistoric humans and even today, especially with the onslaught of AIDS, remains a great imitator. Duodenal TB is rare and usually presents with gastroduodenal obstruction or dyspeptic symptoms. Obstruction is usually extrinsic, from matted lymph nodes. TB ulceration often is postbulbar and is associated with periduodenal lymphadenopathy. It may be complicated by obstruction, perforation, and fistula formation, but bleeding is unusual. As in this case, TB ulcers in the duodenum typically have a cratered appearance with mass-like edges. On histology, TB organisms are few and usually do not form well-developed granulomas in patients with AIDS. In contrast, its close relative, MAI, displays many organisms and sheets of histiocytes. Think of TB for postbulbar ulcers, especially if the patient has high-risk behavior or hails from an area in which AIDS is endemic. Lawrence J. Brandt, MD Associate Editor for Focal Points |
Vol 64 - N° 4
P. 648-649 - octobre 2006 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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