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Abstract：
Tuberculous (TB) disease remains an endemic pathology in Tunisia. the ileocecal region is the predominant site of involvement while gastroduodenal tuberculosis is very rare, this form is often presenting as one of the complications, mainly upper gastrointestinal stenosis or exceptionally as a perforation. We describe a case of female patient aged 33 years-old presented with a 2-day history of acute abdominal pain, with a tenderness of the right hypochondrium and the epigastrium, ultrasound of the abdomen revealed gallbladder distension with a wall thickening. The diagnosis of acute cholecystitis was suspected and the patient had an exploratory laparoscopy that revealed the presence of a perforated duodenal ulcer which was blocked by the gallbladder and several peri-duodenal lymph nodes. Cholecystectomy was performed and the edges of the ulcer were resected and the ulcer was sutured. Histological examination revealed duodenal tuberculosis and the patient was referred to the TB eradication program.
摘要：
结核性（TB）疾病仍然是突尼斯的一种地方性病理。回盲区是受累的主要部位，而胃十二指肠结核非常罕见，这种形式通常是并发症之一，主要为上消化道狭窄或异常为穿孔。我们描述了一例33岁的女性患者，有2天的急性腹痛病史，右软骨下体和上腹部有压痛，腹部超声显示胆囊扩张，壁增厚。怀疑诊断为急性胆囊炎，该患者进行了探查性腹腔镜检查，发现十二指肠溃疡穿孔被胆囊和十二指肠周围淋巴结阻塞。进行胆囊切除术，切除溃疡边缘，缝合溃疡。组织学检查显示十二指肠结核，患者被转诊至结核病根除计划。
