Disseminated Tuberculosis Presenting as Gastric Outlet Obstruction
A 12-year-old female had a three-year history of fever, non-bilious vomiting and abdominal pain. Upper gastrointestinal series showed a filling defect at the duodenum. Esophagogastroduodenoscopy exhibited circumferential
mass extending from the duodenal bulb to the 2nd part of the duodenum which on histology disclosed chronic
granulomatous inflammation. Chest X-ray suggested miliary tuberculosis; endotracheal tube aspirate was PCR
positive for Mycobacterium tuberculosis. Patient was diagnosed as disseminated tuberculosis of the duodenum
and lungs. Quadruple anti-tuberculosis medication was started but patient succumbed to nosocomial sepsis.