Gastric Tuberculosis Accompanied by Cutaneous Fistula: A Case Report

Abstract

Gastric Tuberculosis (TB) is a rare presentation. Posterior gastric perforation with tuberculosis complications is extremely unusual. The authors herewith present a case of a 32-year-old male, with complaints of fever for two months and discharge from the left-side of the back for 15 days, through which ingested food particles were drained. The patient was a known case of Type 2 Diabetes Mellitus (T2DM) and was recently diagnosed with pulmonary TB. He was evaluated with an upper Gastrointestinal (GI) endoscopic biopsy, Contrast-enhanced Computed Tomography (CECT), and Gastrografin (GGF) studies to confirm the diagnosis. He presumably developed gastric ulceration with posterior perforation, tracking through the retroperitoneum and presenting as a subcostal abscess that was inadvertently incised and converted into a fistula. He was treated both medically and surgically. He recovered completely and discharged with full course of Antitubercular Treatment (ATT) drugs and didactic medications. The presence of a cutaneous fistula in association with gastric TB underscores the diverse clinical presentations of this infectious disease, emphasising the importance of early detection and tailored management approaches.

Keywords

• gastrografin study
• laparotomy
• posterior perforation
• subcostal abscess
• tuberculous granuloma