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Pancreatic tuberculosis with obstructive jaundice--a case report.

C H Chen¹, C C Yang, Y H Yeh

¹Show-Chwan Memorial Hospital, Changhua, Taiwan, Republic of China.

The American Journal of Gastroenterology

|September 14, 1999

Summary

Pancreatic tuberculosis (TB) is rare and can mimic pancreatic cancer. This case highlights the importance of considering TB in differential diagnoses, even with atypical presentations, leading to successful treatment with antimicrobial therapy.

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Area of Science:

Gastroenterology
Infectious Diseases
Surgical Oncology

Background:

Pancreatic tuberculosis (TB) is an exceedingly rare condition.
Diagnosis and treatment of pancreatic TB remain challenging and controversial.

Observation:

An 82-year-old male presented with obstructive jaundice and abdominal pain, initially suspected as pancreatic cancer.
Imaging revealed a pancreatic head mass causing biliary and pancreatic duct stricturing.
The patient underwent a Whipple procedure due to suspected malignancy.

Findings:

Histopathology confirmed pancreatic tuberculosis, involving the pancreatic head, lymph nodes, and ampulla of Vater.
The patient responded well to a 6-month course of anti-TB antimicrobial therapy.
No recurrence was observed on follow-up ultrasound.

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Implications:

This case underscores the necessity of including pancreatic TB in the differential diagnosis of pancreatic head masses.
Early and accurate diagnosis, even in atypical presentations, is crucial for appropriate management.
Successful treatment with antimicrobial therapy can be achieved, avoiding extensive surgery in some cases.