scholarly journals A rare case of primary gastric tuberculosis presenting as gastric outlet obstruction mimicking malignancy

2018 ◽  
Vol 4 (10) ◽  
pp. 263
Author(s):  
Kanika Singh ◽  
Sujata Raychaudhuri ◽  
Sheetal Gole ◽  
Anu Aggarwal
Keyword(s):  
Weight Loss ◽  
Differential Diagnosis ◽  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Rare Condition ◽  
Surgical Excision ◽  
Giant Cells ◽  
Endoscopic Biopsy ◽  
Gastric Tuberculosis

<p>Gastric tuberculosis (TB), both primary and secondary is a rare condition. It is less common in immunocompetent individuals and in those without any antecedent pulmonary infection. The nonspecific complaints like epigastric pain, vomiting and weight loss may be confounding and lead to difficulty in diagnosis and differential diagnosis may include adenocarcinoma. We present a case of an immunocompetent male who presented with the above mentioned symptoms and on endoscopy showed an ulcerated region in the pyloric antrum with gastric outlet obstruction. A differential diagnosis of adenocarcinoma was suggested by the clinician. The endoscopic biopsy revealed granulomas and giant cells with no evidence of dysplasia. However, Ziehl-Neelson stain for acid fast bacilli was negative. The diagnosis of gastric tuberculosis was confirmed on Polymerase chain reaction (PCR) test for TB. A possibility of gastric tuberculosis should always be kept in mind in an endemic country like India with nonspecific abdominal complaints like epigastric pain, weight loss, vomiting etc. along with other differential diagnosis. A correct clinicopathological diagnosis would help in the appropriate treatment of the patient and would prevent unnecessary surgical excision.</p>

scholarly journals Unusual Tissue – Unusual Issue: Pancreatic Heterotopia Presenting as Gastric Outlet Obstruction

2021 ◽  
pp. 338-343
Author(s):  
Thu L. Nguyen ◽  
Shivani Kapur ◽  
Stephen C. Schlack-Haerer ◽  
Grzegorz T. Gurda ◽  
Milan E. Folkers
Keyword(s):  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Needle Aspiration ◽  
Pancreatic Tissue ◽  
Cystic Mass ◽  
Pancreatic Heterotopia ◽  
History Of

Pancreatic heterotopia (PH) is a common, but typically small (<1 cm), incidental and asymptomatic finding; however, PH should be considered even for large and symptomatic upper gastrointestinal masses. A 27-year-old white woman presented with a 3-week history of burning epigastric pain, nausea, early satiety, and constipation. Physical examination revealed epigastric and right upper quadrant tenderness with normal laboratory workup, but imaging revealed a 5-cm, partly cystic mass arising from the gastric antrum with resulting pyloric stenosis and partial gastric outlet obstruction. Endoscopic ultrasound-guided fine needle aspiration revealed PH – an anomalous pancreatic tissue lying in a nonphysiological site. The patient ultimately underwent a resection and recovered uneventfully, with a complete pathologic examination revealing normal exocrine pancreatic tissue (PH type 2) without malignant transformation. We report a case of heterotopic pancreas manifesting as severe gastric outlet obstruction, in addition to a thorough diagnostic workup and surgical follow-up, in a young adult. Differential diagnoses and features that speak to benignity of a large, symptomatic mass lesion (PH in particular) are discussed.

Gastric dysplasia causing gastric outlet obstruction

2021 ◽  
Vol 14 (7) ◽  
pp. e243208
Author(s):  
Rahul Kumar ◽  
Ipsit Ilahi ◽  
Tripti Prajapati ◽  
Pankaj Kumar Garg
Keyword(s):  
Gastric Outlet Obstruction ◽  
Distal Gastrectomy ◽  
Histopathological Examination ◽  
Outlet Obstruction ◽  
Endoscopic Biopsy ◽  
Tissue Growth ◽  
Radiological Findings ◽  
Gastric Dysplasia ◽  
Gastric Contents ◽  
Atypical Cells

Gastric dysplasia signifies the presence of atypical cells in the gastric mucosa, which have not invaded beyond the lamina propria, and it rarely leads to tissue growth large enough to cause gastric outlet obstruction (GOO) to the gastric contents. However, GOO is commonly observed as a first clinical manifestation of advanced invasive gastric cancer in developing countries where patients seek medical care late. The present case highlights the treatment journey of a young woman who presented to us with features of GOO. Her endoscopic and radiological findings revealed a nodular gastric antral thickening causing GOO. An endoscopic biopsy showed features of dysplasia. She underwent distal gastrectomy following discussion in a multidisciplinary tumour board. Histopathological examination of the gastrectomy specimen confirmed dysplasia without any invasion beyond lamina. To the best of our knowledge, this is perhaps the first report of dysplasia of the stomach presenting as GOO.

scholarly journals Rapunzel syndrome causing partial gastric outlet obstruction requiring emergency laparotomy

2020 ◽  
Vol 13 (1) ◽  
pp. e232904
Author(s):  
Robert Lyons ◽  
Granit Ismaili ◽  
Michael Devine ◽  
Haroon Malik
Keyword(s):  
Ct Scan ◽  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Postoperative Recovery ◽  
Emergency Laparotomy ◽  
Rapunzel Syndrome ◽  
History Of

A 16-year-old girl with a background of childhood trichophagia presented with a 2-day history of epigastric pain and associated anorexia with vomiting. An epigastric mass was palpable on examination. A CT scan revealed an intragastric trichobezoar, extending into the duodenum consistent with Rapunzel syndrome with evidence of partial gastric outlet obstruction and a possible perforation. The patient underwent an urgent laparotomy and extraction of the trichobezoar. The bezoar was removed without complication and no intraoperative evidence of perforation was detected. After an uncomplicated postoperative recovery, she was discharged home with psychiatric follow-up.

scholarly journals Giant Hepatic Hemangioma Presenting as Gastric Outlet Obstruction

2013 ◽  
Vol 98 (1) ◽  
pp. 19-23 ◽  
Author(s):  
Cemalettin Aydin ◽  
Sami Akbulut ◽  
Koray Kutluturk ◽  
Aysegul Kahraman ◽  
Cuneyt Kayaalp ◽  
...  
Keyword(s):  
Weight Loss ◽  
Abdominal Pain ◽  
Gastric Outlet Obstruction ◽  
Benign Tumor ◽  
Significant Proportion ◽  
Outlet Obstruction ◽  
Left Lobe ◽  
Hepatic Hemangioma ◽  
Giant Hepatic Hemangioma

Abstract Hemangioma, a most frequently encountered primary benign tumor of the liver, is generally determined incidentally during the course of radiologic tests for other reasons. Most lesions are less than 3 cm and a significant proportion of patients are asymptomatic, although the size and location of the lesion in some patients may be associated with the onset of symptoms. Pressure on the stomach and duodenum of giant hemagiomas developing in the left lobe of the liver, in particular, may result in the development of abdominal pain, nausea, vomiting, and feeling bloated, which are characteristic of a gastric outlet obstruction. A 42-year-old man presented with findings of gastric outlet obstruction and weight loss as a result of a giant hepatic hemangioma.

scholarly journals Gastric Outlet Obstruction Due to Cholecysto-Gastric Fistula: Bouveret’s Syndrome

2020 ◽  
Keyword(s):  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Outlet Obstruction ◽  
Diagnostic Value ◽  
Gastric Fistula ◽  
Bouveret’S Syndrome ◽  
X Ray ◽  
Gastrointestinal Obstruction ◽  
Biliary Enteric Fistula ◽  
Bouveret's Syndrome

Bouveret’s syndrome is defined as gastrointestinal obstruction due to an impacted gallstone secondary to biliary-enteric fistula. This is often observed with nonspecific symptoms such as epigastric pain, nausea, and vomiting. The diagnosis is made by visualization of pneumobilia, gastric outlet obstruction and ectopic gallstone. In this report, we discussed an elderly patient who was admitted to the emergency department with abdominal pain and vomiting without any signs of bowel obstruction in plain x-ray and ultrasound imaging. We aimed to remind the importance of clinical suspicion and the diagnostic value of computed abdominal tomography for emergency physicians.

scholarly journals Bouveret’s syndrome: A challenging case of gastric outlet obstruction.

2020 ◽  
Vol 27 (06) ◽  
pp. 1316-1319
Author(s):  
Marrium Gul ◽  
Irfan Qadir ◽  
Muhammad Qasim Butt
Keyword(s):  
Gastric Outlet Obstruction ◽  
Epigastric Pain ◽  
Duodenal Bulb ◽  
Outlet Obstruction ◽  
Postoperative Recovery ◽  
Blood Analysis ◽  
Bouveret’S Syndrome ◽  
Endoscopic Extraction ◽  
Bilioenteric Fistula ◽  
Bouveret's Syndrome

Bouveret’s syndrome causes gastric outlet obstruction when a gallstone is impacted in the duodenum or stomach via a bilioenteric fistula. We present case of a 40-year-old female presented with epigastric pain and intractable vomiting for 2 days. Her physical examination and laboratory workup including blood analysis, amylase test and lipase test were normal. Plain abdominal X-ray did not show any signs of small bowel obstruction. A nasogastric tube was placed and drained 2.5 L of gastric contents immediately. Esophagogastroduodenoscopy showed a dilated stomach with excessive secretions and a large blackish-brown hard stone in the duodenal bulb. After failed attempt at endoscopic extraction, patient underwent laparotomy and removal of stone via duodenal incision. Subsequently, the patient exhibited a good postoperative recovery. The condition of the patient has remained stable after being followed up for one year.

scholarly journals Treatment of median arcuate ligament syndrome: outcome of laparoscopic approach

2020 ◽  
Vol 33 (1) ◽  
Author(s):  
Julio Cezar Uili COELHO ◽  
Andréa Virmond El HOSNI ◽  
Christiano MarloPaggi CLAUS ◽  
Yan Sacha Hass AGUILERA ◽  
Gisele Pitrowsk ABOT ◽  
...  
Keyword(s):  
Weight Loss ◽  
Epigastric Pain ◽  
Clinical Manifestations ◽  
Laparoscopic Approach ◽  
Rare Condition ◽  
Laparoscopic Treatment ◽  
Median Arcuate Ligament ◽  
Median Arcuate Ligament Syndrome ◽  
Arcuate Ligament ◽  
Operative Findings

ABSTRACT Background: Median arcuate ligament syndrome(MALS) is a rare condition thatmay cause significant clinical manifestations, including abdominal pain and weight loss. Its diagnosis may be difficult and very often delayed. The laparoscopic approach became the standard treatment of MALS. Aim: To assess the outcome of laparoscopic treatment in patients with MALS. Method: The data of sixpatients with MALS who were subjected to laparoscopic sectioning of the median arcuate ligament were retrospectively reviewed.The following data were evaluated: age, gender, clinical and diagnostic tests findings, ASA score, operative findings and complications, postoperative complications and mortality, hospital stay duration, and hospital readmission.The diagnosis of MALS was established by CT angiography and/or MR angiography. Results: There were four (66.7%) women and two (33.3%) men aged from 32 to 60 years. The main symptoms were epigastric pain (100%) and weight loss (66.7%). The findings of high-grade stenosis of the proximal celiac axis and poststenotic dilation confirmed on angiography confirmed the diagnosis in all patients. Surgical procedure was uneventful in all patients. The only postoperative complication was urinary retention that occurred in a male. At three-month follow-up, all patients were asymptomatic. Conclusion: Laparoscopic treatment of MALS is safe and effective in relieving the clinical manifestations of patients.

scholarly journals Application value of tissue tuberculosis antigen combined with Xpert MTB/RIF detection in differential diagnosis of intestinal tuberculosis and Crohn’s disease

2020 ◽  
Author(s):  
Baoying Fei ◽  
Lin Zhou ◽  
Yu Zhang ◽  
Linhe Luo ◽  
Yuanyuan Chen
Keyword(s):  
Differential Diagnosis ◽  
Crohn’S Disease ◽  
Crohn's Disease ◽  
Intestinal Tuberculosis ◽  
Surgical Excision ◽  
Endoscopic Biopsy ◽  
Detection Sensitivity ◽  
Intestinal Tissue ◽  
Tissue Samples ◽  
Tuberculosis Antigen

Abstract Background: The purpose of this study was to evaluate the value of Xpert MTB/RIF detection and tuberculosis antigen detection of Mycobacterium tuberculosis cluster (MTBC) in intestinal tissues for differentiating intestinal tuberculosis (ITB) from Crohn’s disease (CD). Methods: A total of 110 patients who were clinically diagnosed with CD or ITB were monitored. Several specimens of intestinal tissue from endoscopic biopsy or surgical excision were used for culture and Xpert MTB/RIF for detection of MTBC, respectively. Four antigens (38KDa, ESAT-6, MPT64, Ag85 complex) of MTBC in intestinal tissue were detected by immunohistochemistry. Results: A total of 42 cases of intestinal tuberculosis and 46 cases of CD were included in the experimental analysis. Perianal lesions and longitudinal ulcers were more common in CD patients (p < 0.05), while caseous granuloma and annular ulcers were more common in ITB patients (P < 0.05). The positive rate of MTBC detected by Xpert MTB/RIF in intestinal tissue samples of ITB patients was 33.33%, which was significantly higher compared to CD patients (p < 0.05) and compared to acid-fast staining smears (9.52%) (p < 0.05). The positive MPT64 expression rate in patients with intestinal tuberculosis was 40.48%, which was significantly higher than that observed in CD patients, which was 19.56% (p<0.05). Conclusions: The detection of Xpert MTB/RIF in intestinal tissue is a rapid and useful method for establishing an early diagnosis of intestinal tuberculosis. The detection of Xpert MTB/RIF and MPT64 antigen in intestinal tissues have definitive value in the differential diagnosis of intestinal tuberculosis and Crohn’s disease. The combination of these two methods could improve detection sensitivity.

scholarly journals OESOPHAGEAL & GASTRIC CARCINOMA;

2017 ◽  
Vol 24 (08) ◽  
pp. 1105-1109
Author(s):  
Ambreen Mannan ◽  
Suhail Ahmed Soomro ◽  
Tek Chand Maheshwari ◽  
Muhammad Hussain Laghari
Keyword(s):  
Weight Loss ◽  
Gastric Outlet Obstruction ◽  
Complication Rate ◽  
Outlet Obstruction ◽  
University Hospital ◽  
Electrolyte Imbalance ◽  
Billroth I ◽  
Carcinoma Of Esophagus ◽  
Carcinoma Stomach ◽  
Age Range

Objectives: To know the frequency of gastroesophageal carcinoma andits management at Isra University Hospital Hyderabad Sindh. Study Design: Descriptive,Prospective. Place and Duration of Study: Isra University Hospital Hyderabad during the periodof January 2014 to January2016. Patient and Methods: Fifty two patients with gastroesophagealmalignancy were scrutinized for elective and emergency surgery according to the stage andtumor resectability & observed for postoperative complication rate. Data is prepared in SPSSversion 17. Inclusion Criteria: Carcinoma of esophagus and stomach. Exclusion Criteria:Benign lesions of esophagus and stomach (Tuberculosis, Bourevet’s syndrome, Band ofLadd’s, Diaphragmatic Hernia, Phyto/Tricobezoar). Gastric outlet obstruction (GOO) causedby bilio pancreatic, retroperitoneal or abdominal wall mass. Results: Among fifty two patients11(22%) were with carcinoma of esophagus and 41(78%) with carcinoma stomach causingGOO; accounting 38(73%) male & 14(27%) females with age range of 29-69 years. Majorpresenting complaints of carcinoma of esophagus were progressive dysphagia from solid toliquid with significant weight loss while history of heamatemesis was found in only two patients.Carcinoma stomach mainly presented with symptoms of gastric outlet obstruction (GOO);partial or complete I.e. vomiting, fullness and epigastric mass with weight loss. Out of total 52patients; 35 were biopsied and staged preoperatively while 17 patients could not be biopsiedbefore surgery either because of inadequate tissue specimen or scope negotiation problem.However after surgery their biopsy was found out malignant. All such patients were optimizedbefore surgery for correction of hemoglobin, electrolyte imbalance and nutritional supportFeeding jejunostom & gastrojejunostomy were mainly performed for carcinoma esophagus andstomach while for resectable tumors Ivor Lewis, McKeon or Billroth I or II were also performedaccording to the general patient condition and the local resectability of the tumor mass. Ourpost-operative complication rate was 26% and comprised nausea, vomiting, wound infection,and delayed gastric emptying which were treated conservatively. Our operative mortality wasnone. Conclusion: Most of our cases were in advanced stage of malignancy which was mainlydealt with Feeding jejunostomy & Gastrojejunostomy. However Esophagogastric intubation inadvanced malignancy is the safe & effective alternative if available.

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