Post gastrectomy mass: to be TB or not to be TB.Learning objectives were (1) to recognize the relationship between gastrectomy gastrectomy
Surgical removal of all or part of the stomach to treat peptic ulcers. It eliminates the cells that secrete acid and halts the production of gastrin, the hormone that stimulates them. Once a common operation, it is now a last resort. and Mycobacterial tuberculosis infection; and (2) to recognize the surveillance guidelines for post gastrectomy patients. A 73-year-old male with Billroth 2 gastrectomy for PUD PUD
peptic ulcer disease
Peptic ulcer disease (PUD)
A stomach disorder marked by corrosion of the stomach lining due to the acid in the digestive juices. in 1980 presented in June 2003 with 6 months of abdominal pain, weight loss and vomiting. He was diagnosed with Mycobacterium kansasii pulmonary infection in January 2003, started on 3 drugs that he could not tolerate. Abdominal ultrasound, CT and GI series with small bowel follow through in January 2003 were negative. Workup in June 2003 with EGD and biopsy showed gastric stump ulceration. Biopsy showed adenocarcinoma, no AFB or granulomas. Because of his poor performance comfort care was opted. Although gastric adenocarcinoma is common world wide, incidence in the USA has declined. Predisposing factors include H pylori infection, atrophic gastritis, pernicious anemia and gastric resection >15 years ago. Studies show 80% incidence of gastric stump cancer in patients with Billroth 2 gastrectomy. Systemic follow-up of patients who undergo stomach surgery for peptic ulcer disease Peptic ulcer disease (PUD)
A stomach disorder marked by corrosion of the stomach lining due to the acid in the digestive juices.
Mentioned in: Indigestion
peptic ulcer disease See Duodenal ulcer, Gastric ulcer, GERD. is recommended, as early detection is the most important factor contributing to successful treatment. In creased incidence of pulmonary M tuberculosis infection after gastric resection is also seen. M kansasii, an atypical mycobacterium, presents in immunocompetent im·mu·no·com·pe·tent
Having the normal bodily capacity to develop an immune response following exposure to an antigen.
im individuals as lung disease, cellulitis, arthritis or lymphadenitis Lymphadenitis Definition
Lymphadenitis is the inflammation of a lymph node. It is often a complication of a bacterial infection of a wound, although it can also be caused by viruses or other disease agents. . However to our knowledge increased M kansasii infection in gastrectomized patients has not been reported. This case emphasizes the need for diligent follow-up of gastrectomized patients and begs the question: Does partial gastrectomy also makes one susceptible to pulmonary infection by non-tuberculous mycobacteria?
Tripura Mantha Bala, MD, and Mukta Panda, MD. University of Tennessee The University of Tennessee (UT), sometimes called the University of Tennessee at Knoxville (UT Knoxville or UTK), is the flagship institution of the statewide land-grant University of Tennessee public university system in the American state of Tennessee. , Chattanooga Unit, Chattanooga, TN.