Korean Journal of Gastrointestinal Endoscopy 1992;12(2): 263-266.
토혈을 동반한 십이지장결핵 1예 ( A Case of Duodenal Tuberculosis Associated with Hematemesis )
정희진, 송훤택, 송치욱, 이상우, 김창덕, 류호상, 현진해 (Hee Jin Jung, Hwon Taig Song, Chi Wook Song, Sang Woo Lee, Chang Duck Kim, Ho Sang Ryu and Jin Hai Hyun)
Abstract
Despite the marked decreased frequency of tuberculosis in the world by advent of effective chemotherapy, gastrointestinal tuberculosis is considered to be relativeiy frequent in developing countries. Tuberculosis of the duodenum is rare, little reported in the literature. The prevalenoe rates in reports dealing with necropsy observations in patient with pulmonary tuberculosis range from 0.36%-2.3%. Definitive diagnosis will require endoscopic or surgical biopsy because of inconsistent clinical findings, Recently, we experienced a case of duodenal tuberculosis with massive UGI bleeding, masquering as a duodenal ulcer bleeding, and diagnostic confirmation was attained by histologic findings of endoscpic biopsy. A 65-year-old woman was admitted with 3 months history of epigastric discomfort, 1 day history of hematemesis and melena. Urgent endoscopy revealed active bleeding from a large ulcer causing obstruction of the 2 nd portion of duodenum and endoscopic electrocoagulation was performed with success. After a reasonable medical trial, follow-up endascopic examinations of lesion showed no response. So, endoscopic biopsies was done and histopathology revealed multiple granuloma with central necrosis.
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