Pancreatic tuberculosis with obstructive jaundice - A case report

Isolated pancreatic tuberculosis (TB) is very rare and its treatment somewh at controversial. We report a case of pancreatic TB diagnosed as pancreatic carcinoma. An 82-yr-old man presented with right upper abdominal pain and obstructive jaundice, without fever or weight loss. Ultrasonography, comput ed tomography, and endoscopic retrograde cholangiopancreatography showed a mass lesion in the pancreatic head, which caused stricturing of the distal common bile duct and pancreatic duct in the head of the gland. As malignanc y was suspected, he underwent a Whipple procedure (pancreaticoduodenectomy) . Histological examination of the resection specimen disclosed typical feat ures of tuberculosis in the pancreatic head, lymph nodes, and at the ampull a of Vater. The rest of the abdominal cavity was unremarkable. After receiv ing antimicrobial therapy for tuberculosis for 6 months, he remains well, w ithout jaundice or a recurrent mass visible by ultrasound. (Am J Gastroente rol 1999;94:2534-2536. (C) 1999 by Am. Coll. of Gastroenterology).