Tuberculosis is a serious health problem not only in Indonesia, but worldwide. Each year, it occurs in nearly 9.7 million people and claims about 2 million lives worldwide. Pancreatic tuberculosis is a rare type of extra pulmonary tuberculosis that only occur less than 4.7% worldwide. The most common symptoms is abdominal pain and most of the patients shows abdominal tenderness on palpation. Diagnosis of pancreatic tuberculosis consist of tuberculin skin test, ultrasonography, computed tomography-scan, magnetic resonance imaging and biopsy. Diagnosing pancreatic tuberculosis is a challenge because of its rarity and it has similar symptoms as more common pancreatic condition such as pancreatic malignancy. Understanding of pancreatic tuberculosis will increased the clinical awareness that may guide clinicians to avoid unnecessary diagnostic or therapeutic procedures and early diagnosis.
Inflammatory bowel disease is a chronic inflammatory disease that consist of Crohn’s disease and ulcerative colitis. A dramatic increase in the prevalence if inflammatory bowel disease (IBD) within developing countries including in Asia makes IBD a substantial global medical burden and modern refractory disease, and it is imperative that Asian healthcare systems especially physician are aware of this and familiar with the clinical manifestation and management. The aim of this case report is to present a case of IBD in young adult in Indonesia. Patient came with complaint of chronic diarrhea and had seen multiple doctor without improvement. Inflammatory bowel disease should always be considered in patient with chronic diarrhea with or without extraintestinal manifestation especially after poor response of usual antidiarrheal medication. Diagnosing of IBD is based on clinical manifestation, physical examination, laboratory result and endoscopy. Until now, ileocolonoscopy and biopsy is the most accurate diagnostic modality for IBD and can be used to differentiate between ulcerative colitis and Crohn’s disease. Treatment of IBD are drugs such as mesalazine until surgery based on the severity or complication of disease.
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