Gastric Tuberculous Ulcer Perforation Presenting as Acute Peritonitis PD03-PD04
Dr. Zeineb Mzoughi,
Medical Doctor, Department of General Surgery, Centre Hospitalier Universitaire Mongi Slim, Sidi Daoud, Tunis, Tunisia.
Kochâ€™s bacillus infection is a rare cause of gastric ulcer. Gastric perforation associated with tuberculosis is extremely rarely presented as generalised peritonitis. A 39-year-old patient presented with epigastralgia with fever for one week. The physical examination found a generalised abdominal defense. Computed tomography evoked the diagnosis of perforated duodenal ulcer. The patient was operated and a suture excision of a perforated gastric ulcer was performed. The mesentery contained multiple lymph nodes. The small intestine was uniformly carded. The histopathological examination showed a gastric tuberculous ulcer. Acute peritonititis complicating tuberculous duodenal ulcer should be evoked especially in endemic area. Clinical history, abdominal CT scan results, and intraoperative exploration should suggest this diagnosis with therapeutic implications.