위결핵 (胃結核)

A 19 years old female patient was admitted to our department in NSH, because of epigastric pain, vomiting, diarrhea and weight loss(about llkg since last 2 years) on July 8, 1979. The positive physical examinations were moderate degree of diffuse abdominal tenderness, slightly increased bowel sound, absence of axillary and pubic hair ar,d breast atrophy. Laboratory findings were mild degree of anemia, increased ESR, hypoalbuminemia and hypona- tremia. Chest P-A gave normal, but upper G-I series revealed pyloric stricture with rigidity. Barium enema revealed some irregular mucosal patterns and a round filling defect in the cecum and tortousity in terminal ileum. So we urged to have the impression of tuberculosis in stomach and intestine. On gasrofiberscopy, pyloric stricusure with a nuber of small papillary-like protrusions as well as an ulcer which gave graish brown colored base but smooth margin was noted in antrum(lesser curvature side). We treated the patient with antacid and antituberculous medications for 2 weeks, but vomiting and epigastric pain, which was the symptoms of pyloric stricture, was not relieved. So the patient was operated for confirm and treatment on July 24, 1979 Postoperative and histopathologic findings was the Dx of tuberculosis in stomach and intestine. After operation, the above mentioned symptoms were relieved markedly by antituberculous medications. Stomach tuberculosis is a rare disease and the confirmation was attained by pathology. So we report this case with literature study.