Gastric Tuberculosis Accompanied by Cutaneous Fistula: A Case Report
Published: April 1, 2024 | DOI: https://doi.org/10.7860/JCDR/2024/67551.19277
Thulasikumar Ganapathy, Rathnaganpathi Thulasikumar
1. Senior Consultant, Department of Vascular Surgery, SPM Hospital, Chennai, Tamil Nadu, India.
2. Senior Consultant, Department of Vascular Surgery, Saveetha Medical College and Hospital, Saveetha Institute of Medical and Technical Sciences, Chennai, Tamil Nadu, India.
Correspondence Address :
Dr. Rathnaganpathi Thulasikumar,
Senior Consultant, Department of Vascular Surgery, Saveetha Medical College and Hospital, Saveetha Insitute of Medical and Technical Sciences, Saveetha University, Chennai-602106, Tamil Nadu, India.
E-mail: memyself.hari@gmail.com
Abstract
Gastric Tuberculosis (TB) is a rare presentation. Posterior gastric perforation with tuberculosis complications is extremely unusual. The authors herewith present a case of a 32-year-old male, with complaints of fever for two months and discharge from the left-side of the back for 15 days, through which ingested food particles were drained. The patient was a known case of Type 2 Diabetes Mellitus (T2DM) and was recently diagnosed with pulmonary TB. He was evaluated with an upper Gastrointestinal (GI) endoscopic biopsy, Contrast-enhanced Computed Tomography (CECT), and Gastrografin (GGF) studies to confirm the diagnosis. He presumably developed gastric ulceration with posterior perforation, tracking through the retroperitoneum and presenting as a subcostal abscess that was inadvertently incised and converted into a fistula. He was treated both medically and surgically. He recovered completely and discharged with full course of Antitubercular Treatment (ATT) drugs and didactic medications. The presence of a cutaneous fistula in association with gastric TB underscores the diverse clinical presentations of this infectious disease, emphasising the importance of early detection and tailored management approaches.
Keywords
Gastrografin study, Laparotomy, Posterior perforation, Subcostal abscess, Tuberculous granuloma