A rare case of abdominal tuberculosis with vomiting : letter to the editor

A 40-year-old female patient presented with vomiting, consisting of bile and food consumed the previous night, approximately 1 hour after each meal. She had experi- enced this symptom for 4 months, and the vomiting had increased in severity during the previous 2 months. The patient had not experienced abdominal pain, abdominal distension, jaundice or fever. An oesophago-gastro-duo- denoscopy revealed two distal duodenal ulcers. Biopsies (Figs. 1 and 2) revealed non-specific inflammation. The patient was treated with proton pump inhibitors and alu- minium phosphate gel for 2 months, but the vomiting did not improve. A barium meal (Fig. 3) was then adminis- tered, and a colonoscopy (Fig. 4) was performed despite the absence of lower gastrointestinal (GI) symptoms. The barium meal revealed one long stricture in the descend- ing part of the duodenum, and a colonoscopy revealed persistent narrowing of the ascending colon and a cir- cumferential ulcer. In addition, nodular ileitis was noted in the terminal ileum. A biopsy revealed non-specific inflammation, and acid-fast bacilli (AFB) staining was negative.