Isolated pancreatic tuberculosis: a medical disease causing surgical dilemmas: case report and review of literature

ABSTRACT

Tuberculosis [TB] affecting the pancreas is rare even in endemic countries for tuberculosis. The occurrence may pose a diagnostic problem in differentiating it from carcinoma of the pancreas. Clinical examination, laboratory data and imaging are all non-specific. Diagnosis is frequently misguided towards neoplasia requiring surgical intervention. We present one case of isolated pancreatic tuberculosis that was diagnosed by CT guided fine needle aspiration cytology [FNAC] illustrating the value of FNAC in such a situation, thus obviating the need for unnecessary surgery [laparotomy / laparoscopy] with its accompanying morbidity. The patient/s response to antituberculous drugs [quadruple therapy] was excellent. TB should be considered in the differential diagnosis of a pancreatic mass and most patients have an excellent response to standard antituberculous regimen. Thus, maintaining a high index of suspicion can assist in avoiding unnecessary laparotomies. We report this case as it is rare along with review of relevant literature