Pancreatic tuberculosis in a liver transplant recipient: a case report

Abstract

The pancreatic form of tuberculosis (TB) is rare and its diagnosis is challenging, since it manifests itself with non-specific symptoms and non-pathognomonic radiological findings, mimicking a neoplasia of the pancreas. Here, we report the case of a patient who had previously undergone liver transplantation and sought care for abdominal pain, weight loss, anorexia, hematochezia and postprandial fullness. Following an exploratory laparotomy and nucleic acid amplification testing on a pancreatic sample that had been collected, the patient was diagnosed with pancreatic TB. The patient received anti-tubercular pharmacological therapy and required percutaneous biliary drainage. Awareness of the possibility of a pancreatic TB diagnosis is important for clinicians. This attention should be even greater in patients who have undergone transplants, who are immunodeficient or who are from endemic areas.

Figure 1. MRCP showing dilation of the pancreatic duct and a failure in continuity present in the bile duct, suggesting obstruction by a periampullary tumor.

Figure 2. MRCP showing a pancreatic expansive process, causing upstream dilation of the main pancreatic duct.