Pancreaticoduodenal Tuberculosis Simulating Metastatic Ovarian Carcinoma

Abstract

A patient from Thailand presented with symptoms suggestive of peptic ulceration. Radiology showed an ulcerated duodenal stricture, a pancreaticoduodenal mass and extensive retroperitoneal lymphadenopathy suggestive of metastatic carcinoma. Tuberculosis was diagnosed only at laparotomy. The incidence of tuberculosis is increasing, and alimentary tuberculosis should be considered in patients from populations at risk presenting with obscure abdominal complaints or unexplained radiologic findings.

Pancreatic tuberculosis: an elusive diagnosis

“…The common presenting features are non-speci®c abdominal pain, fever, anorexia and weight loss [3][4][5][6][7][9][10][11][12][13]. Less common symptoms include iron-de®ciency anaemia, vomiting, obstructive jaundice, upper gastro-intestinal bleeding and portal hypertension [3,[13][14][15][16]. Patients may or may not have had other forms of tuberculosis in the past.…”

Cystic Space Occupying Lesion (Sol) of Pancreas – Not Always Malignant

“…(10,11,12,13,14) Less common symptoms are iron deficiency anemia, vomiting, obstructive jaundice, hematemesis and portal hypertension. (6,15,16) Xia and colleagues reported 16 patients with pancreatic TB and the presenting symptoms were abdominal pain (75-100%), weight loss (69%), malaise (64%), fever and night sweats (50%). (17) Laboratory abnormalities include anaemia, decreased WBC, increased OT/PT, increased ALP in 50% cases.…”

Adiponectin May Modify the Risk of Barrett’s Esophagus in Patients With Gastroesophageal Reflux Disease

“…(1, 2) Barrett’s esophagus likely represents a metaplastic healing response to esophageal injury, typically from gastroesophageal reflux disease (GERD);(3) its presence increases the risk for esophageal adenocarcinoma by 30–40 fold. (4) Barrett’s esophagus is associated with obesity, especially abdominal obesity, (5, 6) although the biological links between obesity, Barrett’s esophagus, and cancer are unclear.…”