Korean J Gastrointest Endosc > Volume 35(5); 2007 > Article
Korean Journal of Gastrointestinal Endoscopy 2007;35(5): 346-350.
십이지장 누공을 동반한 장결핵 1예
고려대학교 의과대학 내과학교실, 소화기연구소
Intestinal Tuberculosis with a Duodenal Fistula
Eun Bum Park, M.D., Yoon Tae Jeen, M.D., Jae Hong Ahn, M.D., Sang-jun Suh, M.D., Sun Jae Lee, M.D., Nark-Soon Park, M.D., Bora Keum, M.D., Yeon Seok Seo, M.D., Yong Sik Kim, M.D., Hoon Jai Chun, M.D., Hong Sik Lee, M.D., Soon Ho Um, M.D., Sang Woo Lee, M.
Department of Internal Medicine, Institute of Digestive Disease and Nutrition, Korea University College of Medicine, Seoul, Korea
Intestinal tuberculosis is a common disease of extrapulmonary tuberculosis. A diagnosis of intestinal tuberculosis is difficult as the symptoms and laboratory findings are not specific for the disease. Intestinal tuberculosis may cause various complications, such as intestinal obstruction, intestinal perforation, intraabdominal abscess, intestinal hemorrhage and fistula formation. A duodenal fistula caused by tuberculosis is an especially rare condition. We experienced a case of intestinal tuberculosis with a duodenal fistula as a complication. The patient was a 25- year-old man that presented with weight loss and diarrhea. Esophagogastroduodenoscopy showed a deep ulcerative lesion on the third portion of the duodenum with a fistula opening. A histological finding revealed granulomatous inflammation with multinucleated giant cells. In addition, the result of a Tb PCR assay was positive. After two months of treatment with the appropriate medication, the symptoms improved and the fistula has closed completely. We report the case with a review of the literature. (Korean J Gastrointest Endosc 2007;35:346-350)
Key Words: Tuberculosis, Intestinal tuberculosis, Duodenal fistula
주요어: 결핵, 장결핵, 십이지장 누공
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