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Digestive and Liver Disease 45 (2013) 263

Contents lists available at SciVerse ScienceDirect

Digestive and Liver Disease

j our nal ho me page: www.elsev ier .com/ locate /d ld

mage of the Month

astric tuberculous abscesses

érard Thiéfina,∗, Roland Jaussaudb

Department of Hepato-Gastroenterology, Reims University Hospital, Avenue du General Koenig, 51100 Reims, FranceDepartment of Internal Medicine and Infectious Diseases, Reims University Hospital, Avenue du General Koenig, 51100 Reims, France

r t i c l e i n f o

rticle history:eceived 11 July 2012ccepted 5 September 2012vailable online 9 October 2012

Fig. 1.

A 27-year-old African male, recently immigrated to France as war refugee from Sudan presented with abdominal pain andevere cachexia. Clinical examination of the abdomen was nor-al. Laboratory tests showed microcytic anaemia and lymphopeniaith elevated inflammatory markers. Serology for Human Immu-odeficiency Virus (HIV) was negative. A computed tomography ofhe abdomen revealed hypodense collections in the gastric wallFig. 1, white arrows). Upper endoscopy showed several sessile,olypoid lesions in the gastric corpus, 1–3 cm in diameter. Lesioniopsies resulted in evacuation of a caseous material into the gastric

umen (Fig. 2). Direct examination of the material was negative foricroorganisms but culture in specific medium confirmed the pres-

nce of Mycobacterium tuberculosis. The patient was diagnosed withastric tuberculous abscesses; further investigations showed pul-onary and peritoneal tuberculosis. The patient was successfully

reated with a 12-month antituberculosis treatment.Epidemiology of tuberculosis in Western Europe is charac-

erised by a high proportion of cases occurring in immigrants

∗ Corresponding author. Tel.: +33 3 26 78 72 29; fax: +33 3 26 78 40 61.E-mail addresses: gthiefin@chu-reims.fr (G. Thiéfin),

jaussaud@chu-reims.fr (R. Jaussaud).

[

590-8658/$36.00 © 2012 Editrice Gastroenterologica Italiana S.r.l. Published by Elsevierttp://dx.doi.org/10.1016/j.dld.2012.09.001

Fig. 2.

from endemic countries, as illustrated by our observation, andimmunocompromised patients, particularly those with HIV infec-tion. Extrapulmonary tuberculosis accounts for about 20% of allcases. Tuberculous involvement of the gastrointestinal tract is com-mon in the ileocaecal region due to richness of the lymphoid tissue,whereas gastric tuberculosis is uncommon, accounting for only0.5–3% of all cases [1].

Reference

1] Gupta V, Goel MM, Noushif M, et al. Primary gastric tuberculosis mim-icking gastrointestinal stromal tumor. American Journal of Gastroenterology2012;107:1269–70.

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