Souhaib Atri, Magherbi Houcine, Yacine Ouadi, Hadad Anis, Alia Zehani, Chaker Youssef, Kacem Montasser Jamel
Department of Digestive Surgery 'A', La Rabta Hospital University, Faculty of Medicine of Tunis, Tunisia.
Department of Pathological Anatomy, La Rabta Hospital University, Faculty of Medicine of Tunis, Tunisia.
Ann Med Surg (Lond). 2021 May 12;66:102392. doi: 10.1016/j.amsu.2021.102392. eCollection 2021 Jun.
Tuberculous (TB) disease remains an endemic pathology in Tunisia. the ileocecal region is the predominant site of involvement while gastroduodenal tuberculosis is very rare, this form is often presenting as one of the complications, mainly upper gastrointestinal stenosis or exceptionally as a perforation. We describe a case of female patient aged 33 years-old presented with a 2-day history of acute abdominal pain, with a tenderness of the right hypochondrium and the epigastrium, ultrasound of the abdomen revealed gallbladder distension with a wall thickening. The diagnosis of acute cholecystitis was suspected and the patient had an exploratory laparoscopy that revealed the presence of a perforated duodenal ulcer which was blocked by the gallbladder and several peri-duodenal lymph nodes. Cholecystectomy was performed and the edges of the ulcer were resected and the ulcer was sutured. Histological examination revealed duodenal tuberculosis and the patient was referred to the TB eradication program.
结核病在突尼斯仍然是一种地方病。回盲部是主要受累部位，而胃十二指肠结核非常罕见，这种形式常表现为并发症之一，主要是上消化道狭窄，或极少见地表现为穿孔。我们描述了一例33岁女性患者，有2天急性腹痛病史，右季肋区和上腹部压痛，腹部超声显示胆囊扩张伴壁增厚。怀疑为急性胆囊炎，患者接受了探查性腹腔镜检查，发现有一个穿孔的十二指肠溃疡，被胆囊和几个十二指肠周围淋巴结阻塞。进行了胆囊切除术，切除溃疡边缘并缝合溃疡。组织学检查显示为十二指肠结核，患者被转诊至结核病根除项目。
