A Case of Splenic Tuberculosis Forming a Gastro-splenic Fistula.
10.4166/kjg.2015.66.3.168
- Author:
Kyong Joo LEE
1
;
Jin Sae YOO
;
Hosung JEON
;
Sung Kook CHO
;
Ji Hyun LEE
;
Sung Sam HA
;
Mee Yon CHO
;
Jae Woo KIM
Author Information
1. Department of Internal Medicine, Yonsei University Wonju College of Medicine, Wonju, Korea. jawkim96@yonsei.ac.kr
- Publication Type:Case Reports
- Keywords:
Tuberculosis, splenic;
Gastro-splenic fistula;
Granuloma
- MeSH:
Antitubercular Agents/therapeutic use;
Fluoroscopy;
Gastric Fistula/pathology;
Gastroscopy;
Humans;
Male;
Middle Aged;
Spleen/diagnostic imaging/pathology;
Splenic Diseases/*diagnosis/diagnostic imaging/pathology;
Tomography, X-Ray Computed;
Tuberculosis, Splenic/*diagnosis/drug therapy/microbiology;
Ultrasonography
- From:The Korean Journal of Gastroenterology
2015;66(3):168-171
- CountryRepublic of Korea
- Language:English
-
Abstract:
We report a case of a 61-year-old man who presented with a cough and abdominal discomfort. CT scan of the chest showed two lesions across both lungs, and an abdominal CT scan revealed multiple hypodense lesions in the spleen with cystic lesions on the splenic hilum. Upper gastrointestinal tract endoscopy found creamy yellowish discharge through a fistula between the stomach and splenic hilum. Under fluoroscopic guidance, forceps was inserted into the fistula tract, and forcep biopsy was done. The pathology was consistent with tuberculosis, and a nine-month anti-tuberculosis medication regimen was started. Imaging performed three months after finishing medication indicated improvement of splenic lesions, and the gastro-splenic tract was sealed off. This case is a very rare clinical example of secondary splenic tuberculosis with a gastro-splenic fistula formation in an immunocompetent patient.
