Kumar Prashanth Ashok, Singh Gursharan, Joseph John Biku, Swaminathan S, Venkatakrishnan L
PSG Institute of Medical Sciences and Research , Coimbatore, Tamil Nadu, India .
HOD, Department of Liver Transplant Surgery, PSG Institute of Medical Sciences and Research , Coimbatore, Tamil Nadu, India .
J Clin Diagn Res. 2016 Nov;10(11):PD29-PD31. doi: 10.7860/JCDR/2016/22995.8896. Epub 2016 Nov 1.
Pancreatic Tuberculosis is an uncommon form of extra pulmonary tuberculosis that resembles malignancy of pancreas and serve as a diagnostic challenge for physicians. Conservative management with Anti Tuberculosis Therapy (ATT) will suffice for pancreatic tuberculosis whereas a malignancy may require major surgeries which may lead to significant morbidity. Here, we discuss the case of a female patient who presented with abdominal pain and vomiting and is a known case of chronic calcific pancreatitis. Radiological findings were that of malignancy of the pancreas. Enteroscopy showed pus flowing out from the duodenum. Endoscopic Ultrasound (EUS) guided Fine Needle Aspiration Cytology (FNAC) of the pancreas revealed acid fast bacilli. The patient was treated successfully with ATT. Timely diagnosis of this rare form of extra pulmonary tuberculosis can thus help avoid unwanted resections done for presumed malignancy, for which a high index of suspicion is needed.
胰腺结核是肺外结核的一种罕见形式，类似于胰腺恶性肿瘤，给医生带来诊断挑战。抗结核治疗（ATT）的保守治疗对胰腺结核就足够了，而恶性肿瘤可能需要大手术，这可能导致严重的发病率。在此，我们讨论一例女性患者，她因腹痛和呕吐就诊，是已知的慢性钙化性胰腺炎病例。影像学检查结果提示胰腺恶性肿瘤。肠镜检查显示有脓液从十二指肠流出。胰腺的内镜超声（EUS）引导下细针穿刺抽吸细胞学检查（FNAC）发现抗酸杆菌。该患者接受ATT治疗成功。因此，及时诊断这种罕见的肺外结核形式有助于避免因疑似恶性肿瘤而进行不必要的切除，对此需要高度的怀疑指数。
