Edorium Journal of

Gastroenterology

 
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Case Report
 
An unusual cause of pancreatic head mass: Primary pancreatic tuberculosis
V. YaminiChitra1, K. N. Paramesh2
1MS (General Surgery), DNB, MCH (Surgical Gastroenterology), Associate Professor, Dept of Surgical Gastroenterology and Bariatric Centre, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India.
2MS (General Surgery), (DNB Surgical Gastroenterology), Senior Resident, Dept of Surgical Gastroenterology and Bariatric Centre, Vydehi Institute of Medical Sciences and Research Centre, Bangalore, Karnataka, India.

Article ID: 100003G01VC2015
doi:10.5348/G01-2015-3-CR-3

Address correspondence to:
V. YaminiChitra
Associate Professor, Department of Surgical Gastroenterology and Bariatric Centre
Vydehi Institute of Medical Sciences and Research Centre
Bangalore, Karnataka Postal Code-560 066
India
Phone: +919611108242
Fax: 08028412956

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How to cite this article:
YaminiChitra V, Paramesh KN. An unusual cause of pancreatic head mass: Primary pancreatic tuberculosis. Edorium J Gastroenterol 2015;2:7–12.


Abstract
Introduction: In tuberculosis, abdominal involvement occurs in 12% of cases with miliary tuberculosis (TB) and isolated abdominal involvement occurs in 20% of extrapulmonary TB. Isolated tuberculous involvement of pancreas is extremely rare accounting for 5% of these cases. The aim of this case report is to present a rare case of isolated tuberculosis of pancreas in a young nonalcoholic, immunocompetent patient with vague symptomatology and no clinical signs.
Case Report: A 22-year-old male patient presented with vague abdominal pain and weight loss of two months duration. Evaluation revealed a pancreatic head mass with biliary obstruction, endoscopic ultrasound guided fine needle aspiration (EUS–FNA) was inconclusive and preoperative diagnosis of pancreatic neoplasm was made. Patient underwent exploratory laparotomy, it was decided that resection was not possible and therefore a palliative biliary and gastric bypass with biopsy was done. Postoperative histology showed tuberculosis of pancreatic tissue and peripancreatic nodes. The patient was started on antitubercular drugs and improved well.
Conclusion: In a patient with pancreatic mass, a high index of suspicion, use of EUS-FNA with acid-fast bacilli (AFB) staining, TB-PCR and culture techniques help diagnose pancreatic TB and avoid unnecessary surgeries in this totally curable condition.

Keywords: Pancreatic head mass, Tuberculosis, EUS-FNA, TB-PCR


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Author Contributions
V. YaminiChitra – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Revising it critically for important intellectual content, Final approval of the version to be published
K. N. Paramesh – Substantial contributions to conception and design, Acquisition of data, Analysis and interpretation of data, Drafting the article, Final approval of the version to be published
Guarantor of submission
The corresponding author is the guarantor of submission.
Source of support
None
Conflict of interest
Authors declare no conflict of interest.
Copyright
© 2015 V. YaminiChitra et al. This article is distributed under the terms of Creative Commons Attribution License which permits unrestricted use, distribution and reproduction in any medium provided the original author(s) and original publisher are properly credited. Please see the copyright policy on the journal website for more information.



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