A Case of Gastric Tuberculosis with Gastric Cancer Performed Laparoscopic Assisted Distal Gastrectomy

Noriyuki Hirahara, Takeshi Nishi, Yasunari Kawabata, Toko Inao, Seiji Yano, Mitsuo Tachibana, Tsuneo Tanaka, Kunihiko Ueda*, Kazuyuki Matsushita* and Ichiro Ogushi*

Department of Digestive and General Surgery, Shimane University School of Medicine
Department of Surgery, Kyowakai Kyoritsu Hospital*

A 62-year-old man undergoing laparoscopic-assisted distal gastrectomy (LADG) for early gastric cancer and diagnosed with coexistent gastric tuberculosis postoperatively was admitted for appetite loss and tarry stool. Blood analysis showed marked anemia and gastrointestinal fiberscopy showed a giant gastric ulcer. Despite conservative therapy, the gastric ulcer was not cured. Gastrointestinal fiberscopy then showed early gastric cancer in addition to the gastric ulcer. After LADG, the man suffered persistent high fever. Histological examination showed gastric tuberculosis in the gastric ulcer. Despite administration of antituberculosis agents, his general condition worsened and he died. Coexistent gastric tuberculosis associated with gastric cancer is rare, but should be included in the differentiated diagnosis of tuberculosis.

Key words
gastric tuberculosis, gastric cancer, laparoscopic-assisted distal gastrectomy

Reprint requests
Noriyuki Hirahara Department of Digestive and General Surgery, Shimane University School of Medicine
89-1 Enya-cho, Izumo, 693-8501 JAPAN

Accepted
March 28, 2007

To read the PDF file you will need Abobe Reader installed on your computer.