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이경주 ( Kyong Joo Lee ),유진세 ( Jin Sae Yoo ),전호성 ( Ho Sung Jeon ),조승국 ( Sung Kook Cho ),이지현 ( Ji Hyun Lee ),하성삼 ( Sung Sam Ha ),조미연 ( Mee Yon Cho ),김재우(교신저자) ( Jae Woo Kim ) 대한소화기학회 2015 대한소화기학회지 Vol.66 No.3
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. (Korean J Gastroenterol 2015;66:168-171)