A Case of Pancreaticobiliary Duct Obstruction due to Pancreatic Tuberculosis Combined with a Colon Adenocarcinoma and Tuberculous Colitis.
- Author:
Lae Seok HWANG
1
;
Seong Woo NAM
;
Seong Eun LEE
;
Nak Hyun KWON
;
Hyo Sung KANG
;
Sung Hoon KIM
;
Kee Suk NAM
;
Kyung Deuk HONG
;
Se Woon HAM
;
Young Woong JEON
;
Se Hyuk PARK
;
Sung Chan JIN
;
Hae Sun AHN
Author Information
1. Department of Internal Medicine, National Medical Center, Seoul, Korea. kn37503@hotmail.com
- Publication Type:Case Report
- Keywords:
Pancreatic tuberculosis;
Biliary obstruction;
Colon cancer;
Colonic tuberculosis
- MeSH:
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
- From:Korean Journal of Gastrointestinal Endoscopy
2007;35(4):267-271
- CountryRepublic of Korea
- Language:Korean
-
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.
