Pancreatic tuberculosis: A case report and review of literature

Background Pancreatic tuberculosis (TB) is a rare clinical condition that is frequently misdiagnosed. A definitive diagnosis is often established through surgical biopsy. Case summary We report a previously healthy 21-year-old male who presented with epigastric pain and fever. Initially diagnosed with a pancreatic abscess and duodenal bulb perforation, the patient declined surgical intervention and was subsequently referred to our hospital. Abdominal computed tomography and endoscopy revealed a duodenal bulb perforation, esophageal and duodenal ulcers, and a mass in the pancreatic head. Endoscopic ultrasound with fine-needle aspiration identified a hypoechoic mass suggestive of TB. Cytological and histopathological analysis confirmed the diagnosis. The patient was diagnosed with primary pancreatic TB and started on anti-TB therapy. At the 1-year follow-up, the pancreatic mass had markedly regressed, and the patient had fully recovered with complete symptom resolution. Conclusion Pancreatic TB should be included in differential diagnosis; prompt endoscopic ultrasound-fine-needle aspiration and therapy enable recovery.