Pancreatic tubercular abscess in a patient of disseminated tuberculosis

Authors

  • Shoiab Mohd Patto Department of Internal Medicine, Sher-e-Kashmir Institute of Medical Science, Srinagar, Kashmir
  • Zubair Ahmad Thoker Department of Internal Medicine, Sher-e-Kashmir Institute of Medical Science, Srinagar, Kashmir
  • Adnan Firdous Raina Department of Internal Medicine, Sher-e-Kashmir Institute of Medical Science, Srinagar, Kashmir

DOI:

https://doi.org/10.18203/2320-6012.ijrms20162349

Keywords:

Disseminated tuberculosis, Pancreatic abscess, Acid fast bacilli

Abstract

Pancreatic tuberculosis is a rare clinical entity, despite the high prevalence of tuberculosis worldwide. When present pancreatic TB is seen usually associated with military/ disseminated TB in  immuno-compromised patients with HIV topping the list in recent times. Here we present an unusual case of an immuno-competent individual with disseminated tuberculosis including pancreatic tubercular abscess a 30-year- old female was admitted with 3 months history of productive cough, constitutional symptoms and persistent epigastric discomfort. Patient had pallor and was febrile with no mass palpable per abdomen. Ultrasonography (USG)/ Contrast enhanced computed tomography (CECT) of abdomen showed cystic pancreatic lesion. Acid fast bacilli (AFB) were demonstrated in sputum as well as  material obtained from USG guided  fine needle aspiration (FNA) of pancreatic lesion which after 6 weeks of incubation showed growth of mycobacterium tuberculosis (MTB) confirming diagnosis of disseminated tuberculosis with pancreatic involvement. Patient was put on antitubercular therapy (ATT) and response was excellent. This case highlights that TB can affect nearly every organ of the body. It should be kept among differentials while evaluating pancreatic lesions. With adequate treatment it is curable.

References

Sharma SK, Mohan A. Extrapulmonary tuberculosis. Indian J Med Res. 2004;120:316-53.

Bhansali SK. Abdominal tuberculosis. Experiences with 300 cases. Am J Gastroenterol. 1977;67:324-37.

Yokoyama T, Miyagawa S, Noike T, Shimada R, Kawasaki S. Isolated pancreatic tuberculosis. Hepatogastroenterology 1999;46:2011-4.

Chen CH, Yang CC, Yeh YH, Yang JC, Chou DA. Pancreatic tuberculosis with obstructive jaundice--a case report. Am J Gastroenterol. 1999;94:2534-6.

Tosun S, Tosun A. Imaging of malignancy-suspected pancreatic involvement of extrapulmonary tuberculosis. Turk J Gastroenterol. 2010;21:54-9.

Sharma SK, Mohan A. Extrapulmonary tuberculosis. Indian J Med Res. 2004;120:316-53.

Turan M, Sen M, Koyuncu A, Aydin C, Elaldi N, Arici S. Pancreatic pseudotumor due to peripancreatic tuberculous lymphadenitis. Pancreatology. 2002;2:561-4.

Meinke AK. Pancreatic tuberculous abscess. Conn Med. 1989;53:139-41.

WHO Global Tuberculosis Report. 2015.

Auerbach O. Acute Generalized Miliary Tuberculosis. Am J Pathol. 1944;20:121-36.

Feng X, Ronnie TPP, Shu GW. Tuberculosis of pancreas and peripancreatic lymph nodes in immunocompetent patients: experience from China. World J Gastroenterol. 2003;9:1361-4.

Saluja SS, Ray S, Pal S, Kukeraja M, Srivastava DN, Sahni P, et al. Hepatobiliary and pancreatic tuberculosis: a two decade experience. BMC Surgery. 2007;7:10.

Sinan T, Sheikh M, Ramadan S. CT features in abdominal tuberculosis: 20 years’ experience. BMC Med Imaging. 2002;2:3-10.

Levine R, Tenner S, Steinberg W, Ginsberg A, Borum M, Huntington D. Tuberculous abscess of the pancreas. Case report and review of the literature. Dig Dis Sci. 1992;37:1141-4.

Ahlawat SK. EUS-guided FNA diagnosis of pancreatic tuberculosis. Gastrointest Endosc. 2007;65:557-8.

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.

Elizondo ME, Arratibel JAA, Compton CC, Warshaw AL. Tuberculosis of the pancreas. Surgery 2001;129(1):114-6.

Downloads

Published

2017-01-04

How to Cite

Patto, S. M., Thoker, Z. A., & Raina, A. F. (2017). Pancreatic tubercular abscess in a patient of disseminated tuberculosis. International Journal of Research in Medical Sciences, 4(8), 3650–3653. https://doi.org/10.18203/2320-6012.ijrms20162349

Issue

Section

Case Reports