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Korean J Gastroenterol. 2015 Dec;66(6):345-349. Korean.
Published online December 22, 2015.  https://doi.org/10.4166/kjg.2015.66.6.345
Copyright © 2015 The Korean Society of Gastroenterology
Asymptomatic Synchronous Tuberculosis Involving Stomach and Small Bowel in Immunocompetent Patient
Jin Soo Chung, Young Bum Cho, Won Gak Heo,1 Dong Ho Jo,1 Young Hun Jeong,1 and Geom Seog Seo1
Gunsan Medical Center, Gunsan, Korea.
1Department of Internal Medicine and Digestive Disease Research Institute, Wonkwang University College of Medicine, Iksan, Korea.

Correspondence to: Geom Seog Seo. Department of Internal Medicine and Digestive Disease Research Institute, Wonkwang University College of Medicine, 895 Muwangro, Iksan 54538, Korea. Tel: +82-63-859-2565, Fax: +82-63-855-2025, Email: medsgs@wonkwang.ac.kr
Received June 26, 2015; Revised July 28, 2015; Accepted August 03, 2015.

This is an open access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Gastrointestinal tuberculosis that is not an unusual form of extrapulmonary tuberculosis and it is usually associated with immunocompromised condition that may present with clinical symptoms including fever, weight loss or pain. Terminal ileum and cecum are the common sites of involvement, but involvement of the stomach is rare. Furthermore, synchronous tuberculosis involving both the stomach and lower gastrointestinal tract has been reported in very few cases. Herein, we report a case of incidentally detected synchronous tuberculosis involving both the stomach and terminal ileum that was successfully treated by antituberculosis therapy in an asymptomatic immunocompetent patient.

Keywords: Intestines; Tuberculosis; Stomach; Asymptomatic diseases

Figures


 Fig. 1
Endoscopic findings. (A) On the gastric antrum, shallow ulcers and elevated erosions with irregular margin were noted. (B) These lesions did not show improvement after administration of proton pump inhibitor for 2 months. (C) On the terminal ileum, transverse ulcers with inflammation were noted. (D, E) After antituberculosis medication for 12 months, previously noted tuberculosis lesions have completely healed.
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Fig. 2
Histologic finding. Endoscopic biopsy specimen obtained from stomach shows granulomatous inflammation with multinucleated giant cell (arrow) (H&E, ×200).
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Fig. 3
CT findings. (A) Focal mild wall thickening is observed on terminal ileum (arrow). (B) Fibrostreaky nodular lesion (arrow) are noted on right upper lung, compatible with inactive tuberculosis.
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Tables


 Table 1
Summary of Four Case Reports of Stomach and Lower Gastrointestinal Tract Tuberculosis
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Notes

Financial support:None.

Conflict of interest:None.

References
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