Gastric outlet obstruction secondary to peptic ulcer disease in a case of abdominal Koch’s

Gastroduodenal tuberculosis (TB) presenting as gastric outlet obstruction is rare and often misdiagnosed, it usually secondary to pulmonary associated with HIV infection. Gastro-duodenal involvement rarer disease (1%) in abdominal TB. We report a case of 43-year-old male no evidence retroviral infection complaints pain since 4 months features obstruction, contrast enhanced computed tomography (CECT) magnetic resonance cholangiopancreatography (MRCP) were suggestive pneumobilia, on endoscopy bilioenteric fistula was confirmed also pan gastritis duodenitis concentric wall thickening noted at D1 D2, although histological examination biopsies showed malignancy or tuberculosis. The diagnosis established after surgery, when specimen an enlarged lymph node sent for histopathological (HPE) GeneXpert the presence giant cells caseating granuloma. surgery performed Roux-en-Y gastrojejunostomy. In this patient gastroduodenal location occurred primary absence other organ involvement. To best our knowledge has been first reported due