Isolated Duodenal Tuberculosis: An Unusual Presentation of Abdominal Tuberculosis

Abstract Duodenal tuberculosis is a rare form of abdominal TB, representing <1% of gastrointestinal involvement, and is often difficult to diagnose due to nonspecific symptoms and subtle imaging findings. This case report describes a 22-year-old female who presented with 2 months of abdominal pain, loss of appetite, and weight loss, with no history of fever, altered bowel habits, or prior tuberculosis. Physical examination was unremarkable except for mild pallor. Routine laboratory investigations showed anemia, and abdominal ultrasonography was normal. Contrast-enhanced computed tomography revealed matted necrotic lymph nodes in the periportal and peripancreatic regions with thickening of the second and third parts of the duodenum. Endoscopy showed a duodenal ulcer, and histopathology demonstrated granulomatous inflammation with caseous necrosis, confirming tuberculosis. Standard antitubercular therapy resulted in complete symptom resolution and endoscopic healing on follow-up. Duodenal TB should be considered in patients with unexplained upper abdominal symptoms to facilitate timely diagnosis and favorable outcomes.