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Pancreatic tuberculosis

G Brusko1, W S Melvin, J J Fromkes

  • 1Ohio Digestive Disease Institute, Grant Medical Center, Columbus, USA.

The American Surgeon
|June 1, 1995
PubMed
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Pancreatic tuberculosis is rare, especially in non-endemic areas. This case highlights isolated pancreatic Mycobacterium tuberculosis infection in a healthy patient, successfully treated with triple drug therapy.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Radiology

Background:

  • Pancreatic tuberculosis is an exceptionally rare condition, typically linked to disseminated miliary tuberculosis or immunocompromised individuals.
  • It is seldom encountered in non-endemic geographical regions, making isolated cases noteworthy.
  • The presentation can be atypical, complicating early diagnosis.

Observation:

  • A healthy North American individual presented with recurrent hyperamylasemia and fevers, symptoms initially suggestive of other pancreatic pathologies.
  • Computed tomography (CT) imaging identified a complex, multiloculated lesion in the pancreatic head.
  • Intraoperative biopsies revealed granulomatous inflammation, a key histological finding.

Findings:

  • Microbiological cultures confirmed the presence of Mycobacterium tuberculosis, establishing the diagnosis of isolated pancreatic tuberculosis.

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  • The patient received standard triple drug therapy for tuberculosis.
  • Post-treatment follow-up CT scans showed complete resolution of the pancreatic lesion.

    • Implications:

    • This case underscores that isolated pancreatic tuberculosis can occur in immunocompetent individuals even in non-endemic regions.
    • Early diagnosis through a combination of imaging, biopsy, and microbiological confirmation is crucial.
    • Effective treatment with standard antitubercular drugs leads to favorable outcomes and complete recovery.