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- Title
Tubercular lymphadenopathy with duodenal fistula.
- Authors
Nasa, Mukesh; Sharma, Zubin; Saraf, Neeraj; Puri, Rajesh
- Abstract
Tuberculosis, both pulmonary and extrapulmonary, is one of the leading causes of significant morbidity and mortality in developing countries. A 29-year-old chronic alcoholic patient presented to gastroenterology outpatient department with complaints of decreased appetite, weight loss, and generalized weakness. On endoscopy, the second part of duodenum appeared edematous with some luminal compromise. There was also presence of an opening in the inferolateral wall of the second part of duodenum, through which milky white caseous material was coming out. Computed tomography demonstrated large conglomerate of paraduodenal, celiac, para-aortic, peripancreatic, and retrocaval nodes with central necrosis. Endoscopic ultrasound showed hypoechoic lymph nodes in paraduodenal, parapancreatic, and celiac axis. Fine needle aspiration cytology showed epithelioid granuloma with Langerhans giant cells suggestive of granulomatous lymphadenitis of tubercular etiology. Tubercular lymphadenopathy eroding into duodenum has been very rarely reported in literature. This case reports the rare possibility of extrinsic tubercular lymphadenopathy eroding into duodenum.
- Subjects
FISTULA; DUODENUM abnormalities; GASTROENTEROLOGY; NEEDLE biopsy
- Publication
Journal of Digestive Endoscopy, 2016, Vol 7, Issue 2, p74
- ISSN
0976-5042
- Publication type
Case Study
- DOI
10.4103/0976-5042.189157