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Pancreatic Tuberculosis
Poras Chaudhary1, Utsav Bhadana1, Mohinder P Arora1
1Department of General Surgery, Lady Hardinge Medical College and Associated Dr Ram Manohar Lohia Hospital, New Delhi, India.
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 symptoms. Ultrasonography/computed tomography/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.
Insights
Pancreatic tuberculosis is a rare condition often mistaken for pancreatic cancer. Early diagnosis and standard antitubercular therapy are key for successful treatment of this unusual pancreatic disease.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Oncology
Background:
- Tuberculosis (TB) of the pancreas is an exceedingly rare condition.
- It frequently mimics pancreatic carcinoma, presenting diagnostic challenges.
- Existing knowledge is primarily derived from isolated case reports.
Purpose of the Study:
- To review the clinical presentation, diagnostic modalities, and management strategies for pancreatic tuberculosis.
- To present the authors' experience with five cases of pancreatic tuberculosis.
Main Methods:
- Review of clinical data, diagnostic imaging (ultrasonography, computed tomography, endosonography), and biopsy results.
- Analysis of treatment outcomes with standard antitubercular therapy.
- Case series of five patients diagnosed with pancreatic tuberculosis.
Main Results:
- Pancreatic tuberculosis can present with diverse imaging findings, including masses, cystic lesions, or abscesses, often mimicking pancreatic cancer.
- Patients may be asymptomatic initially, later developing non-specific symptoms, enlarged lymph nodes, or space-occupying lesions.
- Ultrasound/CT/endosonography-guided biopsy is crucial for diagnosis.
Conclusions:
- Pancreatic tuberculosis should be considered in patients with large space-occupying lesions, necrotic peripancreatic lymph nodes, and constitutional symptoms.
- Definitive diagnosis relies on biopsy.
- Standard antitubercular therapy leads to complete cure in most patients.
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