Tubercular Papillitis of Vater


A middle-aged man with no symptom or history visited our hospital due to duodenal abnormality and fecal occult blood detected by health screening. Upper gastrointestinal endoscopy showed marked enlargement of the papilla of Vater surrounded by nodules, and biopsy disclosed non-caseating granuloma. Colonoscopy yielded findings suggestive of intestinal tuberculosis such as annular ulcers. Examination of the biopsy samples failed to make a diagnosis of tuberculosis, and no pulmonary lesion was found, but whole-blood interferon gamma release assay was positive. The duodenal lesion was also suspected to be tubercular, so antitubercular drugs were administered. As this resulted in the resolution of both lesions, a definite diagnosis of tubercular papillitis of Vater was made. Duodenal tuberculosis is rare, and a localized lesion of the major duodenal papilla is extremely rare. However, this case suggests that tuberculosis must be considered in the differential diagnosis of lesions of the papilla of Vater.

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T. Yamane, T. Ishii, A. Umeda, S. Takagi and H. Shimao, "Tubercular Papillitis of Vater," International Journal of Clinical Medicine, Vol. 3 No. 6, 2012, pp. 469-472. doi: 10.4236/ijcm.2012.36086.

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[1] F. F. Paustian and G. L. Monto, “Tuberculosis of the Intestines,” In: H. L. Bockus, Ed., Gastroenterol, Vol. 2, 1976, pp. 750-777.
[2] T. Mori, M. Sakatani, F. Yamagishi, T. Takashima, Y. Kawabe, et al., “Specific Detection of Tuberculosis Infection with an Interferon-γ-Based Assay Using New Antigens,” American Journal of Respiratory and Critical Care Medicine, Vol. 170, No. 1, 2004, pp. 59-64. doi:10.1164/rccm.200402-179OC
[3] T. Yao, T. Sakurai, J. Yamamoto, I. Hirai, H. Furukawa, et al., “Intestinal Tuberculosis in Recent Years-Analysis of the Reported Cases during the Last Decade in Japan,” Stomach and Intestine, Vol. 30, No. 4, 1995, pp. 485-490.
[4] E. D. Palmer, “Tuberculosis of the Stomach and the Stomach in Tuberculosis,” American Review of Tuberculosis, Vol. 61, No. 1, 1950, pp. 116-130.
[5] J. P. Balikian, S. M. Yenikomshian and Y. D. Jidejian, “Tuberculosis of the Pyloro-Duodenal Area,” American Journal of Roentgenology, Vol. 101, No. 2, 1967, pp. 414-420.

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