Gartini Sara, Ramdani Abdelbassir, Rhazari Meriem, Thouil Afaf, Kouismi Hatim, Aharmim Mohammed, Bourkadi Jamal Eddine
Pneumology Department, Mohammed VI University Hospital, Oujda, Morocco.
Mohammed First University Oujda, Faculty of Medicine and Pharmacy Oujda, Oujda, Morocco.
Ann Med Surg (Lond). 2022 May 4;77:103717. doi: 10.1016/j.amsu.2022.103717. eCollection 2022 May.
Despite the high prevalence of tuberculosis in the world and especially in endemic areas such as Morocco, isolated hepatic and pancreatic tuberculosis and pancreatic tuberculosis remain rare and pose a real diagnostic problem.
We report a case illustrating an exceptional association of pancreatic tuberculosis with hepatic tuberculosis in a 44-year-old immunocompetent woman, in whom the presence of a pancreatic mass on imaging suggested a neoplastic origin. The diagnosis was rectified after bacteriological and pathological study of the CT-guided percutaneous biopsy specimens.
The symptomatology of pancreatic and hepatic tuberculosis is unspecific and polymorphic and can mimic any intra-abdominal pathology. Abdominal ultrasound is often the first imaging modality used. The diagnosis of certainty is bacteriological.The treatment of pancreatic and hepatic tuberculosis is identical to the other extrapulmonary tuberculosis. the anti-bacillary drugs are the gold standard. Surgery is reserved for complicated forms.
The diagnosis of hepatic and pancreatic tuberculosis is a challenge for the clinician. The treatment is usually medical and based on antituberculosis treatment; surgery may be necessary in case of complications.
尽管结核病在全球尤其是在摩洛哥等流行地区的发病率很高，但孤立性肝结核、胰腺结核以及肝胰联合结核仍然罕见，并且构成了一个真正的诊断难题。
我们报告了一例44岁免疫功能正常女性的病例，该病例显示胰腺结核与肝结核罕见地同时出现，其影像学检查发现胰腺有肿块，提示肿瘤性病变。经CT引导下经皮活检标本的细菌学和病理学研究后确诊。
肝结核和胰腺结核的症状缺乏特异性且多样，可模仿任何腹部疾病。腹部超声通常是首先使用的影像学检查方法。确诊依靠细菌学检查。肝结核和胰腺结核的治疗与其他肺外结核相同。抗结核药物是金标准。手术仅适用于复杂病例。
肝结核和胰腺结核的诊断对临床医生来说是一项挑战。治疗通常采用药物治疗，基于抗结核治疗；如有并发症可能需要手术治疗。
