Primary gastroduodenal tuberculosis presenting as gastric outlet obstruction: A case report and review of literature

BACKGROUND

Mycobacterium tuberculosis (TB) is the causative agent of TB, a chronic granulomatous illness. This disease is prevalent in low-income countries, posing a significant global health challenge. Gastrointestinal TB is one of the three forms. The disease can mimic other intra-abdominal conditions, leading to delayed diagnosis owing to the absence of specific symptoms. While gastric outlet obstruction (GOO) remains a frequent complication, its incidence has declined with the advent of proton pump inhibitors and Helicobacter pylori eradication therapy. Gastroduodenal TB can cause upper gastrointestinal hemorrhage, obstruction, and malignancy-like tumors.

CASE SUMMARY

A 23-year-old male presented with recurrent epigastric pain, distension, nausea, vomiting, and weight loss, prompting a referral to a gastroenterologist clinic. Endoscopic examination revealed distorted gastric mucosa and signs of chronic inflammation. However, treatment was interrupted, possibly owing to vomiting or comorbidities such as human immunodeficiency virus infection or diabetes. Subsequent surgical intervention revealed a dilated stomach and diffuse thickening of the duodenal wall. Resection revealed gastric wall effacement with TB.

CONCLUSION

Primary gastric TB is rare, frequently leading to GOO. Given its rarity, suspicions should be promptly raised when encountering relevant symptoms, often requiring surgical intervention for diagnosis and treatment.

Colorectal intussusception with rectal prolapse related to cecal lipoma in adult: A rare case report and review of the literature

Colonic intussusception due to lipoma is extremely rare. Very few cases were reported in the literature of cecal lipoma leading to the intussusception of the whole proximal colon till the rectum. We report a rare case of a 39-year-old female patient with cecal lipoma causing colo-colonic intussusception involving the entire length of the proximal colon and the overall mass prolapsed into the pelvis that could be palpated in rectal examination. The case presented with a giant mass with clinical manifestations of obstruction. An extended right hemicolectomy and end ileostomy were performed due to intestinal dilation and intra-abdominal contamination. To the best of our knowledge, this is the second case of cecal lipoma leading to intussusception of the whole proximal colon till to the rectum reported in the relevant literature. Whenever a colonic mass results in intussusception, the incidence of malignancy is slightly higher (60%), so a proper oncological resection should be performed if the pathology is not known preoperatively.

•

Colonic intussusception due to lipoma is extremely rare. Very few cases were reported in the literature of cecal lipoma leading to the intussusception of the whole proximal colon till the rectum.

•

To the best of our knowledge, this is the second case of cecal lipoma leading to intussusception of the whole proximal colon till to the rectum reported in the relevant literature.

•

Whenever a colonic mass results in intussusception, the incidence of malignancy is slightly higher (60%), so a proper oncological resection should be performed if the pathology is not known preoperatively.