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KMID : 0614620150660030168
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Korean Journal of Gastroenterology
2015 Volume.66 No. 3 p.168 ~ p.171
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A Case of Splenic Tuberculosis Forming a Gastro-splenic Fistula
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이경주:Lee Kyong-Joo
유진세:Yoo Jin-Sae/전호성:Jeon Ho-Sung/조승국:Cho Sung-Kook/이지현:Lee Ji-Hyeon/하성삼:Ha Sung-Sam/조미연:Cho Mee-Yon/김재우:Kim Jae-Woo
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Abstract
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We report a case of a 61-year-old man who presented with a cough and abdominal discomfort. CT scan of the chest showed two lesions across both lungs, and an abdominal CT scan revealed multiple hypodense lesions in the spleen with cystic lesions on the splenic hilum. Upper gastrointestinal tract endoscopy found creamy yellowish discharge through a fistula between the stomach and splenic hilum. Under fluoroscopic guidance, forceps was inserted into the fistula tract, and forcep biopsy was done. The pathology was consistent with tuberculosis, and a nine-month anti-tuberculosis medication regimen was started. Imaging performed three months after finishing medication indicated improvement of splenic lesions, and the gastro-splenic tract was sealed off. This case is a very rare clinical example of secondary splenic tuberculosis with a gastro-splenic fistula formation in an immunocompetent patient.
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KEYWORD
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Tuberculosis, Splenic, Gastro-splenic fistula, Granuloma
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