1/6 Our case series and systematic review on Gastroduodenal Tuberculosis, an uncommon form of GI TB is now online at @tandfmedicine . #tuberculosis
Key points in the thread below https://www.tandfonline.com/doi/full/10.1080/17474124.2020.1816823">https://www.tandfonline.com/doi/full/...

2/6 Most included reports are from https://abs.twimg.com/emoji/v2/... draggable="false" alt="🇮🇳" title="Flagge von Indien" aria-label="Emoji: Flagge von Indien">. The presentation of this entity can be extremely variable: dydpepsia, non-healing ulcers, ulcerated stricture, gastric outlet obstruction and failure to thrive. Endoscopy: ulcer, stricture, nodules, mass etc

3/6 Not easy to achieve the diagnosis and could require repeat biopsieshttps://abs.twimg.com/emoji/v2/... draggable="false" alt="🔬" title="Mikroskop" aria-label="Emoji: Mikroskop"> , deep biopsies or even EMR. Microbiological positivity is uncommon. EUS for LN and submucosal lesions. Could some of these Gastrodudenal TB diagnosed on basis of granuloma be UGI Crohn& #39;s disease? https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤔" title="Denkendes Gesicht" aria-label="Emoji: Denkendes Gesicht">https://abs.twimg.com/emoji/v2/... draggable="false" alt="🤔" title="Denkendes Gesicht" aria-label="Emoji: Denkendes Gesicht">

4/6 Treatement is with ATT and endscopic dilatation. Dilatation is usually safe and we try to do it slighly late in the course after starting ATT hoping to avoid it in ulcerated narrowings. Ulcers do heal by 2 months (as we have also reported in Intestinal TB). https://abs.twimg.com/emoji/v2/... draggable="false" alt="✂️" title="Schere" aria-label="Emoji: Schere"> in nonresponse

5/6 If we even encounter a case startify the disease
DIPS https://abs.twimg.com/emoji/v2/... draggable="false" alt="👇" title="Rückhand Zeigefinger nach unten" aria-label="Emoji: Rückhand Zeigefinger nach unten">
Diagnostic category: Microbiological positive or Clinically diagnosed
Involvement Category (Primary or Secondary)
Presentation (Outlet obstruction or other)
Site (Stomach, Duodenum or both)

6/6 Finally follow up is the key: Has the patient gained weight, has outlet obstruction improved, have the ulcers healed? Suggest that repeat endoscopy is in order in all patients who did not have microbiological positivity