Pancreatic tuberculosis with a pancreaticobiliary fistula.
Pancreatic tuberculosis (TB) is a rare condition that is sometimes difficult to differentiate from pancreatic cancer or other malignancies. A 75-year-old man was admitted to our hospital because of weight loss, fever, and diarrhea. Abdominal ultrasonography and computed tomography (CT) revealed a 3-cm mass in the pancreas head with abdominal lymphadenopathy. Endoscopic retrograde cholangiopancreatography did not show pancreatic duct stenosis or dilatation, but a pancreaticobiliary fistula was demonstrated. Cytological and bacteriological examinations of the pancreatic juice and bile were negative. Endoscopic ultrasonography-guided fine needle aspiration of the mass was not diagnostic. Colonoscopic features and biopsy specimens affirmed the diagnosis of TB, and treatment with antitubercular drugs was started. The pancreatic mass disappeared within 8 weeks and the pancreaticobiliary fistula resolved.
Nakai
Yousuke
Y
Department of Gastroenterology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-8655, Japan. ynakai-tky@umin.ac.jp
Tsujino
Takeshi
T
Kawabe
Takao
T
Kogure
Hirofumi
H
Sasaki
Takashi
T
Yamamoto
Natsuyo
N
Sasahira
Naoki
N
Isayama
Hiroyuki
H
Tada
Minoru
M
Omata
Masao
M
D000368:Aged; D000995:Antitubercular Agents / Q000627:therapeutic use; D001658:Biliary Fistula / Q000209:etiology*; D002760:Cholangiopancreatography, Endoscopic Retrograde; D003108:Colonic Diseases / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy; D003113:Colonoscopy; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D010182:Pancreatic Diseases / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D010185:Pancreatic Fistula / Q000209:etiology*; D010190:Pancreatic Neoplasms / Q000175:diagnosis*; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D014376:Tuberculosis / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy / Q000209:etiology; D014385:Tuberculosis, Gastrointestinal / Q000150:complications / Q000175:diagnosis* / Q000188:drug therapy
D000995:Antitubercular Agents