Korean J Gastrointest Endosc.  2007 Oct;35(4):267-271.

A Case of Pancreaticobiliary Duct Obstruction due to Pancreatic Tuberculosis Combined with a Colon Adenocarcinoma and Tuberculous Colitis

• Hwang LS
• Nam SW
• Lee SE
• Kwon NH
• Kang HS
• Kim SH
• Nam KS
• Hong KD
• Ham SW
• Jeon YW
• Park SH
• Jin SC
• Ahn HS

Abstract

Systemic manifestation of tuberculosis is common, but tuberculous biliary obstruction of the pancreas and a colon adenocarcinoma with combined colonic tuberculosis is an uncommon disorder. We encountered a case of the above condition in 63-year-old male that was admitted to our hospital because of fever, diffuse abdominal pain and rigidity. Abdominal computed tomography showed biliary and pancreatic duct dilatation with left colonic wall thickening and surrounding peritoneal infiltration. Emergency segmental resection of the descending colon with intraoperative T-tube choledochostomy was performed due to the colon mass and biliary obstruction. A colonofiberoscopy was performed for low abdominal pain and hematochezia at 12 days after surgery. It showed multiple colonic ulcerations with a partial stricture. A colonic biopsy showed granulomatous inflammation with acid-fast bacilli. The cause of the biliary obstruction was also revealed as pancreatic tuberculosis by an intraoperative pancreatic and mesenteric biopsy. The patient improved after antituberculous treatment and the patient has been in good health until the last outpatient follow-up visit.

Keyword

Pancreatic tuberculosis; Biliary obstruction; Colon cancer; Colonic tuberculosis

MeSH Terms

Abdominal Pain
Adenocarcinoma*
Biopsy
Choledochostomy
Colitis*
Colon*
Colon, Descending
Colonic Neoplasms
Constriction, Pathologic
Dilatation
Emergencies
Fever
Follow-Up Studies
Gastrointestinal Hemorrhage
Humans
Inflammation
Male
Middle Aged
Outpatients
Pancreas
Pancreatic Ducts
Tuberculosis*
Ulcer