In a case report, the rate condition of tuberculosis of the pancreas is described. There are two conceivable ways in which the pancreas may become diseased: 1. toxic-allergic reaction of the pancreas in response to generalized tuberculosis (so-called concomitant pancreatis) 2. Invasion of the pancreas by tubercle bacteria disseminated via the blood, or through penetration of the organ by adjacent caseating abdominal lymph nodes. Histologically, epithelioid cells and Langhans' giant cells are only rarely found; caseation usually develops, with subsequent calcification, which can lead to stenosis of the pancreatic duct. In patients with generalized tuberculosis and abdominal complaints, the diagnosis is most reliably established on the basis of ERCP and CAT. In the presence of pain, resection of the affected portion of the pancreas may be considered as means of treatment.
In 11 persons with normal pancreas function and 21 patients with chronic pancreatitis serum levels of insulin and C-peptide were measured under basal conditions and after maximal stimulation with glucose-tolbutamide-glucagon. Patients with the highest excretory deficiency in the secretin-pancreozymin test had the most marked impairment in endocrine function. In patients with manifest diabetes the exocrine capacity was reduced to an average of 10% of normal. The endocrine parameters correlated linearly with the exocrine ones, most markedly C-peptide reserve with pancreatic enzyme secretion.
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