Maulahela Hasan, Annisa Nagita Gianty, Syam Ari Fahrial, Stephanie Marini, Dwina Billianti Yayi
Division of Gastroenterology, Department of Internal Medicine, Pancreatobilliary and Digestive Endoscopy, Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Central National Hospital, Jakarta, Indonesia.
Faculty of Medicine Universitas Indonesia, Dr. Cipto Mangunkusumo General Central National Hospital, Jakarta, Indonesia.
Case Rep Gastroenterol. 2024 Jul 30;18(1):379-385. doi: 10.1159/000540293. eCollection 2024 Jan-Dec.
Gastrointestinal tuberculosis (TB), specifically gastric TB, is a rare form of extrapulmonary TB. Diagnosis proves challenging with nonspecific signs and symptoms. In this case report, a 22-year-old male came in with complaints of recurrent hematemesis and melena.
We found a submucosal mass with ulceration in the stomach cardia on esophagoduodenoscopy (EGD). The endoscopic ultrasound (EUS) finding was a hypoechoic submucosal lesion with a clear margin; specimens were taken using fine needle aspiration (FNA) for further histopathological examination. The result indicated granuloma of in pathology, suggesting that the diagnosis was gastric TB. The patient was then treated with antitubercular therapy regimen for 9 months. The previously documented mass in the stomach cardia was no longer visible on the follow-up endoscopy examination, and the patient was considered cured.
This case shows that gastric tuberculosis should be considered in patients with gastrointestinal symptoms, especially those living in TB endemic regions. Endoscopic examinations, such as EGD and EUS, may aid in the diagnosis of gastric tuberculosis.
胃肠道结核（TB），尤其是胃结核，是肺外结核的一种罕见形式。由于症状和体征不具特异性，诊断颇具挑战性。在本病例报告中，一名22岁男性因反复呕血和黑便前来就诊。
我们在食管十二指肠镜检查（EGD）中发现胃贲门处有一个伴有溃疡的黏膜下肿块。内镜超声（EUS）检查发现是一个边界清晰的低回声黏膜下病变；使用细针穿刺抽吸（FNA）获取标本进行进一步的组织病理学检查。病理结果显示为肉芽肿，提示诊断为胃结核。随后该患者接受了9个月的抗结核治疗方案。在随访内镜检查中，先前记录的胃贲门处肿块已不可见，患者被认为已治愈。
本病例表明，对于有胃肠道症状的患者，尤其是生活在结核病流行地区的患者，应考虑胃结核的可能。内镜检查，如EGD和EUS，可能有助于胃结核的诊断。
