review of literature on clinical pancreatology - The Pancreapedia

It was described a case <strong>of</strong> pancreatic tuberculosis in an immunocompromized individual. Afifty-year-old African-American gentleman with history <strong>of</strong> HIV non-compliant on anti-retroviraltherapy presented with epigastric pain for five weeks duration. CT scan <strong>of</strong> abdomen showedlarge necrotic node on the posterior aspect <strong>of</strong> the head <strong>of</strong> pancreas and multiple cysticmasses adjacent to the pancreas. Acid fast bacilli were found on staining <strong>of</strong> CT guidedbiopsy <strong>of</strong> the node. Cultures grew Mycobacterium tuberculosis. Anti-tubercular therapy wasinitiated and resulted in gradual resolution <strong>of</strong> symptoms [638].Pancreatic involvement in tuberculosis is known but uncommon. The clinical manifestationmay vary from painless obstructive jaundice due to pancreatic mass (cyst or abscess) t<strong>of</strong>ever <strong>of</strong> unknown origin. It was reported a case who initially presented as acute pancreatitisrelapsing into chronic pancreatitis as an initial manifestation <strong>of</strong> disseminated tuberculosis[639].Isolated pancreatic tuberculosis (TB) is extremely rare, even in countries where TB isendemic. The recent increased reporting <strong>of</strong> TB <strong>of</strong> the pancreas is related to a worldwideincrease in TB and an increase in emigration from countries where TB is endemic intocountries where more sophisticated healthcare and diagnostic facilities are available. Herein,we report an unusual case <strong>of</strong> isolated pancreatic region TB, which presented with dyspepticsymptoms and was diagnosed by ultrasonography-guided needle aspiration and computedtomography scan <strong>of</strong> the abdomen. Pancreatic TB should be considered as a differentialdiagnosis <strong>of</strong> a pancreatic mass and most patients have an excellent clinical response tostandard antituberculosis regimens [640].