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Pancreatic tuberculosis
Last reviewed: 07.07.2025
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Pancreatic tuberculosis is very rare, even in patients with active pulmonary tuberculosis it is detected, according to various authors, only in 0.5-2% of cases. Tuberculosis mycobacteria enter the pancreas by hematogenous, lymphogenous or contact (from affected neighboring organs) routes.
[ Pathomorphology
Tuberculous lesions of the pancreas can occur with the formation of miliary tubercles, solitary tubercles, caverns, and also in the form of interstitial pancreatitis with subsequent sclerosis 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 tuberculosis of the lungs and other organs. In other cases, patients complain of belching, loss of appetite, nausea, pain in the upper left quadrant of the abdomen, often of a girdle nature, diarrhea, increased thirst (with a violation of the internal secretion of the pancreas), progressive exhaustion, increased sweating, malaise, fever. The skin of patients sometimes acquires a darkish color, as in Addison's disease. When palpating the pancreas, pain is noted in the place of its location, but it is usually impossible to feel it.
The course of the disease is mainly determined by the severity of damage to the lungs and other organs.
Where does it hurt?
Diagnosis of pancreatic tuberculosis
The diagnosis of pancreatic tuberculosis is difficult. Pancreatic tuberculosis can be suspected in a patient with pulmonary tuberculosis when the above symptoms suspicious of pancreatic damage appear. To confirm the diagnosis, ultrasound, pancreatoangiography, retrograde pancreatoductography, scanning of the pancreas, and examination of its external and internal secretion (function insufficiency is characteristic) are performed. Tuberculin tests are usually sharply positive.
Differential diagnosis is carried out between non-specific 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. Fractional 5-6 meals a day, a gentle diet with limited fat content, exclusion of spicy foods and an increase in protein content are prescribed. In case of signs of exocrine pancreatic insufficiency, pancreatin and other enzyme preparations are prescribed, as in chronic pancreatitis.
Drugs