Diagnosis and management of isolated pancreatic tuberculosis: recent experience and literature review

The increased reporting of tuberculosis of the pancreas is related to a worldwide increase in tuberculosis and an increase in emigration from countries where tuberculosis is endemic into countries where more sophisticated healthcare and radiological imaging are available. Three recent cases of pancr...

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Bibliographic Details
Published in:	ANZ journal of surgery Vol. 74; no. 5; pp. 368 - 371
Main Authors:	Woodfield, John C., Windsor, John A., Godfrey, Catherine C., Orr, David A., Officer, Neil M.
Format:	Journal Article
Language:	English
Published:	Oxford, UK Blackwell Science Pty 01-05-2004
Subjects:	abdominal tuberculosis Adult Diagnosis, Differential Female Humans Male Middle Aged Pancreatic Diseases - diagnosis Pancreatic Diseases - microbiology Pancreatic Diseases - therapy pancreatic pseudotumour pancreatic tuberculosis Tomography, X-Ray Computed Tuberculosis - diagnosis Tuberculosis - therapy
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Summary:	The increased reporting of tuberculosis of the pancreas is related to a worldwide increase in tuberculosis and an increase in emigration from countries where tuberculosis is endemic into countries where more sophisticated healthcare and radiological imaging are available. Three recent cases of pancreatic tuberculosis in Auckland, New Zealand, emphasize that tuberculosis should now be included in the differential diagnosis of a pancreatic mass. Diagnostic indicators include emigration from, or recent travel to, a country where tuberculosis is endemic, the association of a pancreatic mass with fever, the presence of abdominal pain and a cystic pancreatic mass in a younger male. Radiological appearances might be similar to a mucinous cystic neoplasm or could show a pancreatic mass with involvement of peripancreatic lymph nodes or a mass centred in a peripancreatic lymph node. When the diagnosis is suspected an human immunodeficiency virus test and a comprehensive screening for tuberculosis at other sites should be performed. If tuberculosis is unable to be diagnosed then pancreatic biopsy and culture is indicated. Endoscopic ultrasound with fine needle aspiration for cytology is likely to become the preferred technique. Most patients have an excellent clinical response to standard antituberculosis regimens.
Bibliography:	ark:/67375/WNG-CPW6VNZC-3 istex:FB87ACC3E1B483EE924E25FF63DD3E5850F47522 ArticleID:ANS2996 FRACP, FACSHP J. C. Woodfield MBChB J. A. Windsor N. M. Officer MD, FRACS C. C. Godfrey MBChB, FRACS. MBChB, FRACS D. A. Orr ObjectType-Case Study-3 SourceType-Scholarly Journals-1 content type line 23 ObjectType-Review-1 ObjectType-Feature-5 ObjectType-Report-2 ObjectType-Article-4
ISSN:	1445-1433 1445-2197
DOI:	10.1111/j.1445-1433.2004.02996.x