Minimally invasive management of obstructive gastroduodenal tuberculosis

Abstract

Pulmonary tuberculosis (TB) is prevalent in Western urban centers, especially among immunocompromised patients and immigrants. However, TB enteritis is a rare sequela, occurring in less than 1 per cent of this population. Tuberculosis may affect any portion of the gastrointestinal (GI) tract, and 85 per cent of cases manifest in the ileocecal region. However, the stomach and duodenum are involved in just 0.3-2.3% of TB cases that affect the gut. Gastric outlet obstruction due to TB has been traditionally treated by a surgical bypass operation, followed by anti-TB chemotherapy. In a recent review of 17 cases of TB-related gastric outlet obstruction, gastrojejunostomy or duodenojejunostomy was performed in all patients. We present a case of gastric outlet obstruction due to TB that was treated successfully with a minimally invasive approach, without the need for a gastric bypass.