Log in with your email address username.

×

Important notice

doctorportal Learning is on the move as we will be launching a new website very shortly. If you would like to sign up to dp Learning now to register for CPD learning or to use our CPD tracker, please email support@doctorportal.com.au so we can assist you. If you are already signed up to doctorportal Learning, your login will work in the new site so you can continue to enrol for learning, complete an online module, or access your CPD tracker report.

To access and/or sign up for other resources such as Jobs Board, Bookshop or InSight+, please go to www.mja.com.au, or click the relevant menu item and you will be redirected.

All other doctorportal services, such as Find A Doctor, are no longer available.

Primary abdominal tuberculosis presenting as chronic dyspepsia

- Featured Image

To the Editor: Tuberculosis (TB) continues to be a leading cause of preventable morbidity and mortality worldwide. Although Australia has the lowest rates in the world, more recently there has been a spike secondary to increased international travel and migration.1

TB can affect virtually any organ system in the body and can present with atypical or non-specific symptoms. A population-based study in America found that classical symptoms of cough and fever of > 2 weeks’ duration and weight loss were variably present and were insensitive predictors for TB.2

A 51-year-old immunocompetent man who had migrated from Somalia 18 years previously presented with a 6-year history of being treated with proton pump inhibitors for chronic duodenal ulcers. Repeated gastroscopies showed oedematous thickened duodenum. He had a 6-month history of anorexia, nausea, vomiting and weight loss, and was referred for diagnostic laparoscopy for suspected gastrointestinal malignancy.

A computed tomography scan of the abdomen showed small coeliac axis lymph nodes and oedematous thickened duodenum (Box). Gastroscopic biopsy samples over the past 6 years had shown chronic inflammation but no granulomas. Laparoscopy showed florid peritoneal nodules suggestive of miliary TB. A biopsy sample was positive for polymerase…

email