Pancreatic tuberculosis-abdominal tuberculosis presenting as pancreatic abscesses and colonic perforation.
Isolated pancreatic tuberculosis is an extremely rare condition, more so in an immunocompetent individual. Its presentation as pancreatic abscesses with colonic perforation has not been reported so far. This condition poses difficulties in clinical diagnoses. Herein we report a case who was operated in another hospital for pancreatic abscesses, and referred to our institution later when he developed fecal peritonitis due to colonic perforation. Re-laparotomy, resection and exteriorisation of the colon were done. Acid fast bacilli was seen in the histopathological examination of the resected colon. The patient responded remarkably to anti-tuberculous therapy and two sittings of debridement. Post procedure the patient developed pancreatic fistula, which was managed successfully with stenting. Pancreatic tuberculosis should be considered as a differential diagnosis when pancreatitis is atypical.
Veerabadran
Premanayagam
P
Department of Surgical Gastroenterology, Sri Ramachandra Medical College and Research Institute, 67, Ramasamy salai, K K Nagar, Chennai 600078, Tamilnadu, India. premnayagam@lycos.com
Sasnur
Prasad
P
Subramanian
Sankar
S
Marappagounder
Subramanian
S
D018784:Abdominal Abscess / Q000209:etiology*; D000328:Adult; D003108:Colonic Diseases / Q000209:etiology*; D006801:Humans; D007416:Intestinal Perforation / Q000209:etiology*; D008297:Male; D010182:Pancreatic Diseases / Q000150:complications / Q000175:diagnosis*; D014385:Tuberculosis, Gastrointestinal / Q000150:complications / Q000175:diagnosis*