Pancreatic Tuberculosis

Abstract

Tuberculosis of the pancreas is extremely rare and in most of the cases mimics pancreatic carcinoma. There are a number of case reports on pancreatic tuberculosis with various different presentations, but only a few case series have been published, and most of our knowledge about this disease comes from individual case reports. Patients of pancreatic tuberculosis may remain asymptomatic initially and manifest as an abscess or a mass involving local lymph nodes and usually present with non-specific features. Pancreatic tuberculosis may present with a wide range of imaging findings. It is difficult to diagnose tuberculosis of pancreas on imaging studies as they may present with masses, cystic lesions or abscesses and mass lesions in most of the cases mimic pancreatic carcinoma. As it is a rare entity, it cannot be recommended but suggested that pancreatic tuberculosis should be considered in cases with a large space occupying lesions associated with necrotic peripancreatic lymph nodes and constitutional sympt o m s . U l t r a s o n o g r a p h y / c o m p u t e d t o m o g r a p h y / endosonography-guided biopsy is the recommended diagnostic technique. Most patients achieve complete cure with standard antituberculous therapy. The aims of this study are to review clinical presentation, diagnostic studies, and management of pancreatic tuberculosis and to present our experience of 5 cases of pancreatic tuberculosis.

Calcified peripancreatic lymph nodes in pancreatic and hepatic tuberculosis mimicking pancreatic malignancy

“…Several excellent articles summarized and reviewed clinical manifestations of pancreatic tuberculosis previously. [ 2 , 7 , 12 – 15 ] The clinical manifestations can be diverse and are commonly caused by the mass in pancreas and/or tuberculous toxaemia. They include abdominal or back pain/discomfort, palpable abdominal lump, jaundice, weight loss, anorexia, fever, night sweats, malaise/weakness/fatigue.…”

“…They include abdominal or back pain/discomfort, palpable abdominal lump, jaundice, weight loss, anorexia, fever, night sweats, malaise/weakness/fatigue. [ 2 , 7 , 12 – 15 ] The diagnosis of pancreatic tuberculosis can easily be missed or significantly delayed because of its rarity and lack of specific manifestations. [ 2 , 7 , 11 ] Kim et al [ 11 ] reported that in about 52% of cases, first impression was wrong as pancreatic or peripancreatic malignancy.…”

“…[ 4 , 5 ] The diagnosis of pancreatic tuberculosis can easily be missed or significantly delayed because of its rarity and lack of specificity. [ 2 , 3 , 6 , 7 ] Two articles reported the isolated tuberculosis lesion at liver or around the head of pancreas involved both liver and pancreas. [ 8 , 9 ] One article reported pancreatic and hepatic tuberculosis without involvement of other organs in an infant.…”

Isolated Pancreatic Tuberculosis Mimicking Pancreatic Cancer: A Diagnostic Challenge

“…Once the diagnosis is confirmed, medical management (antitubercular therapy (ATT)) is the mainstay of the therapy. ATT consists of multidrug chemotherapy and is usually recommended for 6 to 12 months [15]. The disease responds well to the treatment.…”

A 25-Year-Old Woman With a Deceptive Pancreas Cyst: All Is Not as It Appears!

“…For immunocompetent patients, treatment consists of RIPE therapy for 2 to 4 months followed by continuation of INH and rifampin for a total of 6 to 12 months of treatment. 2 In patients with concern for potential INH resistance, as in this case, substitution of INH with moxifloxacin or concomitant treatment with moxifloxacin is appropriate. Medical therapy is curative for pancreatic and disseminated intra-abdominal TB, although in the setting of lesions resulting in obstruction of the biliary tree, endoscopic stenting may be necessary in the early treatment phase.…”