Detailed Abstract
[E-poster - Biliary & Pancreas (Biliary Disease/Surgery)]
[EP 200] Pancreatic And Biliary Tuberculosis Presenting As Obstructive Jaundice in a 32-Year Old Male
Nona Nicole Padua TUPONG 1, Kevin Bryan MARIN 1, Janneth TAN 1
1 Surgery, Jose R. Reyes Memorial Medical Center, Rizal Avenue, Santa Cruz, Manila, Philippines, PHILIPPINES
Background : Pancreatic and biliary tuberculosis (TB) is an uncommon abdominal TB variant posing a diagnostic challenge due to its nonspecific clinical manifestations and elusive radiological features. Typically identified postoperatively through histopathological result, this condition often masquerades as other abdominal pathologies.
Methods : We report a case of 32-year old male presented with a three-month history of right upper quadrant pain, colicky, radiating to the back, jaundice and tea-colored urine. Elevated total bilirubin level and alkaline phosphatase levels were noted with ultrasound findings suggestive of choledocholithiasis. The patient was assessed with obstructive jaundice secondary to choledocholithiasis. Intraoperatively, a pancreatic head mass with multiple hepatic nodules was discovered hence underwent biopsy of the said nodules, trans-cystic cholangiography, choledochotomy, choledochoscopy, cholecystectomy, and Roux-Y hepaticojejunostomy. Histopathology confirmed pancreatic and biliary tuberculosis, and the patient responded well to six months of anti-TB therapy.
Results : Pancreatic and biliary tuberculosis is infrequent, comprising less than 4.7% of abdominal TB cases in high prevalence regions. Nonspecific clinical manifestations, often result in delayed diagnosis delays in diagnosis, particularly in individuals of lower socio-economic status. Risk factors include immunosuppression, endemic settings, malnutrition, alcohol consumption, and smoking. Diagnosis typically relies on surgical intervention and histopathological examination, with anti-TB therapy being effective if started promptly.
Conclusions : Recognizing pancreatic and biliary TB in cases with abdominal pain accompanied by obstructive jaundice is crucial. Early identification is vital to prevent serious complications, with management involving antituberculosis therapy and, in specific circumstances, surgical intervention. Despite diagnostic challenges, the condition generally carries a favorable prognosis with early recognition and treatment.
Methods : We report a case of 32-year old male presented with a three-month history of right upper quadrant pain, colicky, radiating to the back, jaundice and tea-colored urine. Elevated total bilirubin level and alkaline phosphatase levels were noted with ultrasound findings suggestive of choledocholithiasis. The patient was assessed with obstructive jaundice secondary to choledocholithiasis. Intraoperatively, a pancreatic head mass with multiple hepatic nodules was discovered hence underwent biopsy of the said nodules, trans-cystic cholangiography, choledochotomy, choledochoscopy, cholecystectomy, and Roux-Y hepaticojejunostomy. Histopathology confirmed pancreatic and biliary tuberculosis, and the patient responded well to six months of anti-TB therapy.
Results : Pancreatic and biliary tuberculosis is infrequent, comprising less than 4.7% of abdominal TB cases in high prevalence regions. Nonspecific clinical manifestations, often result in delayed diagnosis delays in diagnosis, particularly in individuals of lower socio-economic status. Risk factors include immunosuppression, endemic settings, malnutrition, alcohol consumption, and smoking. Diagnosis typically relies on surgical intervention and histopathological examination, with anti-TB therapy being effective if started promptly.
Conclusions : Recognizing pancreatic and biliary TB in cases with abdominal pain accompanied by obstructive jaundice is crucial. Early identification is vital to prevent serious complications, with management involving antituberculosis therapy and, in specific circumstances, surgical intervention. Despite diagnostic challenges, the condition generally carries a favorable prognosis with early recognition and treatment.
SESSION
E-poster
E-Session 03/21 ALL DAY