Abstract
Objective
To evaluate the radiological findings of duodenal tuberculosis with particular emphasis on the barium findings.
Material and Methods
A retrospective analysis of 805 cases of gastrointestinal tuberculosis from January 1997 to December 2011 over a period of 15 years was conducted. Thirty two cases (4%) of duodenal tuberculosis were found. The diagnosis of duodenal tuberculosis was based on histopathology following surgery or endoscopic biopsy from the duodenum, ultrasound-guided aspiration cytology/biopsy of lymph nodes or response to anti-tubercular treatment. The patients’ clinical presentation was broadly classified into obstructive features and dyspeptic features. Single and/ or double contrast upper gastrointestinal barium studies were reviewed in each case for the segment involved, presence and length of strictures, ulcerations, polypoidal masses, extrinsic impression and complications (viz. perforations and fistulae).
Results
The study included 20 males and 12 females with age range of 7–70 years (mean age 26.6 years) Twenty-seven (84.3%) patients presented with obstructive symptoms and five (15.6%) had predominantly dyspeptic symptoms. The radiological findings in patients with obstructive symptoms were duodenal strictures (n = 19), extrinsic compression (n = 10) and polypoidal intraluminal mass with luminal narrowing (n = 3). Among the patients presenting with dyspeptic symptoms, the most common findings was duodenal ulcerations (n = 3). Perforation was seen in 4 cases and fistulisation in 2 cases. A multiplicity of findings was noted in 7 patients.
Conclusion
Barium studies though not specific for duodenal tuberculosis helped to delineate the mucosal lesions and define the nature, level, and extent of obstruction in these patients.
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References
Abrams JS, Holden WD (1964) Tuberculosis of gastrointestinal tract. Arch Surg 89:282–293
Bhansali SK, Abdominal TB (1977) Experiences with 300 cases. Am J Gastroenterol 67:324–337
Lundstedt C, Nyman R, Brismar J, Hugosson C, Kagevi I (1996) Imaging of tuberculosis. II. Abdominal manifestations in 112 patients. Acta Radiol 37:489–495
Marshall JB (1993) Tuberculosis of the gastrointestinal tract and peritoneum. Am J Gastroenterol 88:989–999
Kolawole TM, Lewis EA (1975) A radiologic study of tuberculosis of the abdomen (gastrointestinal tract). Am J Roentgenol Radium Ther Nucl Med 123:348–358
Gupta SK, Jain AK, Gupta JP, Agrawal AK, Berry K (1988) Duodenal tuberculosis. Clin Radiol 39:159–161
Vijayraghavan M, Arunabh , Sarda AK, Sharma AK, Chatterjee TK (1990) Duodenal tuberculosis: a review of the clinicopathologic features and management of 12 cases. Jpn J Surg 20:526–529
Chavhan GE, Ramakantan R (2003) Duodenal tuberculosis: radiological features on barium studies and their clinical correlation in 28 cases. J Postgrad Med 49:214–217
Gleason T, Prinz RA, Kirsch EP, Jablokow V, Greenlee HB (1979) Tuberculosis of the duodenum. Am J Gastroenterol 72:36–40
Tishler JM (1979) Duodenal tuberculosis. Radiology 130:593–595
Misra D, Rai RR, Nundy S, Tandon RK (1988) Duodenal tuberculosis presenting as bleeding peptic ulcer. Am J Gastroenterol 83:203–204
Schwartz DT, Garnes HA, Lattimer JK, Roberts TW (1970) Pyeloduodenal fistula due to tuberculosis. J Urol 104:373–375
Eadie DG, Pollock DJ (1968) A complicated aortoduodenal fistula. A case report. Br J Surg 55:314–317
Chaudhary A, Bhan K, Malik N, Dilawari JB, Khanna SK (1989) Choledocho-duodenal fistula due to tuberculosis. Ind J Gastroenterol 8:293–294
Gupta P, Debi U, Sinha SK, Prasad KK (2014) Upper gastrointestinal barium evaluation of duodenal pathology: a pictorial review. World J Radiol 6:613–618
Levine MS, Rubesin SE, Pantongrag-Brown L, Buck JL, Herlinger H (1997) Non-Hodgkin’s lymphoma of the gastrointestinal tract: radiographic findings. AJR Am J Roentgenol 168:165–172
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Nagi, B., Lal, A., Gupta, P. et al. Radiological findings in duodenal tuberculosis: a 15-year experience. Abdom Imaging 40, 1104–1109 (2015). https://doi.org/10.1007/s00261-014-0302-y
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DOI: https://doi.org/10.1007/s00261-014-0302-y