Isolated Pancreatic Tuberculosis Mimicking Focal Pancreatitis and Causing Segmental Portal Hypertension
DOI:
https://doi.org/10.6092/1590-8577/3629Keywords:
Endosonography, Pancreas, Tomography, X-Ray Computed, TuberculosisAbstract
Context Isolated pancreatic tuberculosis is a common mimicker of pancreatic malignancy and a common presentation is abdominal pain. However, segmental portal hypertension is very uncommon. Case report A case of isolated pancreatic tuberculosis mimicking focal pancreatitis and causing segmental portal hypertension is presented. Conclusion A histological or microbiological diagnosis of the presence of pancreatic masses is necessary to detect potentially treatable diseases, such as tuberculosis, in endemic countries like India.
Image: CECT showing the bulky head and body of the pancreas with heterogeneous areas of non-enhancement suggestive of necrosis and peripancreatic fat stranding.
Downloads
References
Yokoyama T, Miyagawa S, Noike T, Shimada R, Kawasaki S. Isolated pancreatic tuberculosis. Hepatogastroenterology 1999; 46:2011-14. [PMID 10430386]
Woodfield JC, Windsor JA, Godfrey CC, Orr DA, Officer NM. Diagnosis and management of isolated pancreatic tuberculosis: recent experience and literature review. ANZ J Surg 2004; 74:368-71. [PMID 15144259]
Bhansali SK. Abdominal tuberculosis. Experiences with 300 cases. Am J Gastroenterol 1977; 67:324-37. [PMID 879148]
Auerbach O. Acute generalized miliary tuberculosis. Am J Pathol 1944; 210:121-36. [PMID 19970738]
Stambler JB, Klibaner MI, Bliss CM, Lamont JT. Tuberculous abscess of the pancreas. Gastroenterology 1982; 83:922-5. [PMID 7106522]
Stock KP, Riemann H, Stadler W, Rosch W. Tuberculosis of the pancreas. Endoscopy 1981; 13:178-80. [PMID 7250088]
Teo LLS, Venkatesh SK, Ho KY. Clinic in diagnostic imaging. Singapore Med J 2007; 48:687-92. [PMID 17609835]
Foo FJ, Verbeke CS, Guthrie JA, Ala A, Menon KV. Pancreatic and peripancreatic tuberculosis mimicking malignancy. JOP. J Pancreas (Online) 2007; 8:201-5. [PMID 17356244]
Singh DK, Haider A, Tatke M, Kumar P, Mishra PK. Primary pancreatic tuberculosis masquerading as a pancreatic tumor leading to Whipple's pancreaticoduodenectomy. A case report and review of the literature. JOP. J Pancreas (Online) 2009; 10:451-6. [PMID 19581756]
Tan KK, Chen K, Liau KH, Ho CK. Pancreatic tuberculosis mimicking pancreatic carcinoma: series of three cases. Eur J Gastroenterol Hepatol 2009; 21:1317-9. [PMID 19474749]
Dang S, Atiq M, Saccente M, Olden KW, Aduli F. Isolated tuberculosis of the pancreas: a case report. JOP. J Pancreas (Online) 2009; 10:64-6. [PMID 19129619]
Morán Sánchez S, Rincón Fuentes JP, Nicolas de Prado I, Martínez Madrid OJ, Candel Erenas JM, García Pérez B, et al. Pancreatic tuberculosis with duodenal fistula. Gastroenterol Hepatol 2007; 30:457-60. [PMID 17949612]
Pandya G, Dixit R, Shelat V, Dixit K, Shah N, Shah K. Obstructive jaundice: a manifestation of pancreatic tuberculosis. J Indian Med Assoc 2007; 105:133-4. [PMID 17824465]
Nakai Y, Tsujino T, Kawabe T, Kogure H, Sasaki T, Yamamoto N, et al. Pancreatic tuberculosis with a pancreaticobiliary fistula. Dig Dis Sci 2007; 52:1225-8. [PMID 17372824]
Sachdev A, D'Cruz S, Chauhan S, Thakur R, Kapoor V, Handa U. Pancreaticobiliary tuberculosis diagnosed by endoscopic brushings. JOP. J Pancreas (Online) 2006; 7:665-9. [PMID 17095849]
Takhtani D, Gupta S, Suman K, Kakkar N, Challa S, Wig JD, Suri S. Radiology of pancreatic tuberculosis: a report of three cases. Am J Gastroenterol 1996; 91:832-4. [PMID 8792708]
De Backer AI, Mortele KJ, Bomans P, De Keulenaer BL, Vanschoubroeck IJ, Kockx MM. Tuberculosis of the pancreas: MRI features. AJR Am J Roentgenol 2005; 184:50-4. [PMID 15615950]
Evans JD, Hamanaka Y, Olliff SP, Neoptolemos JP. Tuberculosis of the pancreas presenting as metastatic pancreatic carcinoma. Dig Surg 2000; 17:183-7. [PMID 10781988]
Saluja SS, Ray S, Pal S, Kukaraja M, Srivastava DN, Sahni P, Chattopadhyay TK. Hepatobiliary and pancreatic tuberculosis: a two decade experience. BMC Surg 2007; 7:10. [PMID 17588265]
Song TJ, Lee SS, Park DH, Lee TY, Lee SO, Seo DW, et al. Yield of EUS-guided FNA on the diagnosis of pancreatic/peripancreatic tuberculosis. Gastrointest Endosc 2009; 69:484-91. [PMID 19231490]
Ahlawat SK. EUS-guided FNA diagnosis of pancreatic tuberculosis. Gastrointest Endosc 2007; 65:557-8. [PMID 17321273]
Itaba S, Yoshinaga S, Nakamura K, Mizutani T, Honda K, Takayanagi R, Yamada K. Endoscopic ultrasound-guided fine-needle aspiration for the diagnosis of peripancreatic tuberculous lymphadenitis. J Gastroenterol 2007; 42:83-86. [PMID 17322998]
Coriat R, Latournerie M, Galtier JB, Michiels C, Hillon P, Manfredi S. The role of echoendoscopic biopsy in diagnosing tuberculosis of pancreas. Gastroenterol Clin Biol 2008; 32:98-101. [PMID 18341981]
Chang WC, Chu HC, Tsai SH, Huang GS, Cheng MF, Yu CY. An extraordinary presentation. Am J Med 2009; 122:245-247. [PMID 19272485]
