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Pancreatic Tuberculosis
Last reviewed: 23.04.2024
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Tuberculosis of the pancreas is very rare, even in patients with active pulmonary tuberculosis it is detected, according to different authors, in only 0.5-2% of cases. Tuberculous mycobacteria enter the pancreas with hematogenous, lymphogenic or contact (from affected neighboring organs) pathway.
[Pathomorphology
Tuberculous lesions of the pancreas can occur with the formation of miliary tubercles, solitary tubercles, caverns, as well as in the form of interstitial pancreatitis followed by sclerotherapy of the organ.
Symptoms of Pancreatic Tuberculosis
There may be an asymptomatic course, much more often the symptoms of tuberculosis of the pancreas are masked by more pronounced manifestations of pulmonary tuberculosis and other organs. In other cases, patients complain of belching, loss of appetite, nausea, pain in the upper left quadrant of the abdomen, often surrounding the character, diarrhea, increased thirst (in violation of internal secretion of the pancreas), progressive exhaustion, increased sweating, malaise, febrile condition. The skin of the patients sometimes acquires a darkish color, as with addison's disease. When palpation of the pancreas is noted soreness in its location, but it can not usually be palpated.
The course of the disease is mainly determined by the severity of the lungs and other organs.
Where does it hurt?
Diagnosis of pancreatic tuberculosis
The diagnosis of tuberculosis of the pancreas is difficult. To suspect tuberculosis of the pancreas is possible in a patient with pulmonary tuberculosis, when the above symptoms appear, suspicious for pancreatic cancer. To confirm the diagnosis, ultrasound, pancreatoangiography, retrograde pancreaticoductography, pancreas scanning, examination of its external and internal secretion (characteristic failure of the function) are carried out. Tuberculin samples are usually dramatically positive.
Differential diagnosis is conducted between nonspecific pancreatitis, malignant and benign tumors.
What do need to examine?
How to examine?
Who to contact?
Treatment of pancreatic tuberculosis
It is carried out in specialized anti-tuberculosis clinics with specific anti-tuberculosis drugs. Assign a fractional 5-6 meals a day, sparing a diet with a limited fat content, excluding sharp foods and increasing the protein content. With signs of exocrine pancreatic insufficiency, pancreatin and other enzyme preparations are prescribed, as in chronic pancreatitis.