Abstract
Abdominal Tuberculosis Lymphadenopathy presenting as Portal Hypertension: A Case Report
Villanueva, Ma. Liefe Charmaine E. MD; De Guzman, Roberto N. MD, Renelene A. Macabeo, M.D.3
Our Lady of Lourdes Hospital, Sta. Mesa, Manila
Significance: This case report aims to present an unusual case of Abdominal Tuberculosis causing non- cirrhotic portal hypertension.
Clinical Presentation: Patient is a 63-year-old with no known comorbidities; who came in due to hematemesis and melena. There was no known recent history of NSAID used. On physical examination, patient had stable vital signs, with pallor, and direct tenderness in the epigastric area.
Management: Patient underwent gastroscopy which revealed esophageal varices grade II. An upper abdominal CT scan with contrast was done revealing pancreatic head mass with infiltration into the proximal duodenal segments and associated biliary system dilatation or obstruction and encasement of the main portal vein, celiac trunk and common hepatic artery with perilesional lymphadenopathies. Patient was then started on anti-Koch’s regimen. Patient improved and was discharged. Due to recurrence of hematemesis, he was readmitted after 12 months, hence control of bleeding varices and blood transfusion were done. He eventually underwent Hassab’s procedure and tolerated the procedure well. He was discharged improved and no recurrence of bleeding was reported thereafter.
Recommendation: In the Philippines where case of TB was endemic, diagnosis of gastrointestinal tuberculosis should be part of differential diagnosis of cases with non-cirrhotic portal hypertension and variceal bleeding of unknown cause.
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |