Clinical Analysis of 19 Patients With Pancreatic Tuberculosis / 胃肠病学

ABSTRACT

Background: Pancreatic tuberculosis is relatively rare in clinical practice, its clinical symptoms and imaging findings are lack of specificity, and is easily confused with pancreatic benign and malignant tumors. Aims: To summarize the clinical characteristics of pancreatic tuberculosis. Methods: Data of 19 patients with pancreatic tuberculosis from April 2010 to June 2019 at Xijing Hospital of Digestive Diseases, Air Force Medical University were retrospectively analyzed. Results: Among the 19 patients with pancreatic tuberculosis, 11 were male and 8 were female, median age was 33 years old. Clinical manifestations were mainly abdominal pain or upper abdominal discomfort, fever, night sweat, etc. Laboratory tests showed anemia in 11 patients, increased erythrocyte sedimentation rate in 13 patients, increased amylase in 7 patients, positive T-spot in 9 patients, positive PPD skin test in 3 patients and elevated bilirubin in 5 patients. Imaging examination showed that pancreatic tuberculosis was mainly located in pancreatic head. Ultrasound of the abdomen showed pancreatic mass, changes of internal echo in 8 patients, and pancreatic cystic or solid mass in 11 patients. CT showed significant enlargement of pancreatic head in 5 patients, solid pancreatic occupying lesion in 7 patients, cystic pancreatic occupying lesion in 4 patients, and enlargement of peripancreatic, mesenteric or retroperitoneal lymph nodes in 6 patients. Fourteen endoscopic ultrasound-guided fine-needle aspiration biopsy were performed in 8 patients; 5 patients underwent ultrasound-guided percutaneous biopsy of the occupying lesion. All the patients were given regular anti-tuberculosis treatment, and no relapse was found during the follow-up. Conclusions: For young patients with pancreatic space-occupying lesion, the possibility of pancreatic tuberculosis should be considered. Biopsy is still the current method of diagnosis, and regular anti-tuberculosis treatment is the main treatment for pancreatic tuberculosis.