Duodenal tuberculosis presenting as gatric outlet obstruction

Tuberculosis of stomach and duodenum is very uncommon even in patients with pulmonary and intestinal tuberculosis. Its preoperative diagnosis still remains a challenging problem for surgeons. Herein, we report the case of isolated duodenal tuberculosis in a 42 year old male presenting with gastric outlet obstruction symptoms. Oesophago-gastro-duodenoscopy (UGIE) revealed fold thickening at D3 segment but endoscopic biopsy was inconclusive, CECT abdomen showed ill-defined soft tissue thickening involving the 3(rd) part of duodenum with mesenteric fat stranding. Exploratory laparotomy was done which showed growth at 3rd part of the duodenum and peritoneal seedlings, tissue biopsy was taken and gastro-jejunostomy with jejuno-jejunostomy was done. Histopathological examination was consistent with the features of gastrointestinal tuberculosis. Patient was started on anti-tubercular therapy and was cured of the disease.