Gastroduodenal Tuberculosis: A Rare Cause of Gastric Outlet Obstruction

Gasrtroduodenal tuberculosis is a rare entity with few cases reported in literature. It poses a great diagnostic dilemma and has no clear management guidelines. We report a case of gastro duodenal tuberculosis in a 17 years old male patient who presented with features of gastric outlet obstruction. Oesophago-gastro-duodenoscopy (UGIE) revealed deformed pylorus with stricture in 1st part of duodenum. Abdominal CT showed distended stomach with transition in 1st part of duodenum without any mass lesion or significant lymphadenopathy. Endoscopic biopsy showed non-specific duodenitis. Exploratory laparotomy revealed puckered pylorus, enlarged juxta pyloric lymph nodes without any mass lesion. Intra-operative frozen section biopsy from juxta pyloric lymph node was suggestive of granulamatous inflammation. Truncal vagotomy with gastro-jejunostomy was done and juxta pyloric lymph nodes were sampled for histopathological examination. Final histopathological findings were consistent with features of tuberculosis. Patient was started on anti-tubercular therapy and was cured of the disease.