A Case of Duodenal Fistula Caused by Intra-abdominal Tuberculous Lymphadenopathy during Anti-tuberculous Medication.
- Author:
Kyong Rok LEE
1
;
Kang Seok SEO
;
Jun Ho CHEO
;
Sang Cheol CHOI
;
Kang KIM
;
Youn Gun YIM
;
Gun Young HONG
;
Sang Wook PARK
Author Information
1. Department of Internal Medicine, Kwangju Christian Hospital, Gwangju, Korea. isks123@hanmail.net
- Publication Type:Case Report
- Keywords:
Duodenum;
Fistula;
Tuberculous lymphadenitis
- MeSH:
Adult;
Duodenal Obstruction;
Duodenum;
Edema;
Fellowships and Scholarships;
Fever;
Fistula;
Humans;
Internal Medicine;
Korea;
Lymphatic Diseases;
Tuberculosis;
Tuberculosis, Lymph Node;
Ulcer;
Weight Loss
- From:Korean Journal of Gastrointestinal Endoscopy
2008;37(6):433-437
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Recently, the proportion of extrapulmonary tuberculosis in patients has increased in Korea. Though intestinal tuberculosis in not infrequent, a duodenal fistula caused by tuberculosis is a rare condition. A 29-year-old man was admitted to the Department of Internal Medicine because of fever and weight loss. The patient was a doctor participating in a resident fellowship. The patient was diagnosed with intra-abdominal tuberculous lymphadenopathy and was given anti-tuberculous medication. One month after the administration of medication, the patient showed symptoms and signs of duodenal obstruction because of marked duodenal wall edema and a deep ulcer on the second portion of the duodenum. A computerized tomogram and duodenography revealed the formation of a fistula at the second portion of the duodenum and the presence of abscess-forming tuberculous lymphadenopathy. The use of continuous anti- tuberculous medication resulted in the improvement of the clinical symptoms, with complete healing of the duodenal fistula and tuberculous lymphadenitis. This case suggests that transient clinical worsening in intra-abdominal tuberculous lymphadenitis may occur during an early period of anti- tuberculous medication.
