Pancreatic tuberculosis: a case report


  • Bethany K. Matthews Department of General Surgery, The Royal Brisbane Hospital, Brisbane, Queensland, Australia; University of Queensland, Brisbane, Queensland Australia
  • Pranavan Palamuthusingam Department of General Surgery, The Royal Brisbane Hospital, Brisbane, Queensland, Australia



Mycobacterium, Tuberculosis, Pancreas, Extrapulmonary tuberculosis


Tuberculosis is a bacterial infection secondary to Mycobacterium tuberculosis with highest burden within low socioeconomic communities. Most individuals with tuberculosis infection are immunocompromised due to underlying medical conditions such as human immunodeficiency virus. However, tuberculosis can manifest in immunocompetent individuals although the incidence is significantly less. Pancreatic tuberculosis is exceedingly rare with autopsy series revealing pancreatic tuberculosis <5% of tuberculosis infected individuals. This case report will discuss a 16-year-old female presenting with pancreatic tuberculosis masquerading as possible pancreatic malignancy. Emphasis is placed on the challenging diagnostic nature of pancreatic tuberculosis as it presents with non-specific clinical symptoms which are in keeping with a wide range of differential diagnoses. Once correctly diagnosed pancreatic tuberculosis presents the potential of cure. It is for this reason whilst a rare diagnosis clinicians should be mindful of pancreatic tuberculosis to ensure timely correct treatment is pursued and unnecessary surgical procedures avoided.


Panic N, Maetzel H, Bulajic M, Radovanovic M, Löhr JM. Pancreatic tuberculosis: A systematic review of symptoms, diagnosis and treatment. United European Gastroenterol J. 2020;8(4):396-402.

Chaudhary P, Bhadana U, Arora MP. Pancreatic Tuberculosis. Indian J Surg. 2015;77(6):517-24.

Patterson B, Wood R. Is cough really necessary for TB transmission? Tuberculosis (Edinb). 2019;117:31-5.

Simmons JD, Stein CM, Seshadri C, Campo M, Alter G, Fortune S, Schurr E et al. Immunological mechanisms of human resistance to persistent Mycobacterium tuberculosis infection. Nat Rev Immunol. 2018;18(9):575-89.

Jilani TN, Avula A, Zafar Gondal A et al. StatPearls Active Tuberculosis. Treasure Island (FL): StatPearls Publishing. 2024.

Knowles KF, Saltman D, Robson HG, Lalonde R. Tuberculous pancreatitis. Tubercle. 1990;71:65-8.

Pramesh CS, Heroor AA, Gupta SG, Krishnamurthy S, Shukla PJ, Jagannath P et al. Pancreatic tuberculosis: an elusive diagnosis. HPB (Oxford). 2003;5(1):43-5.

Saluja SS, Ray S, Pal S, Kukeraja M, Srivastava DN, Sahni P et al. Hepatobiliary and pancreatic tuberculosis: a two decade experience. BMC Surg. 2007;7:10.

Rong YF, Lou WH, Jin DY. Pancreatic tuberculosis with splenic tuberculosis mimicking advanced pancreatic cancer with splenic metastases: a case report. Cases J. 2008;1:84.

Anwar A, Hamdan AJ, Salim B, Yosra A, Hani M, Abdullah AH. Diagnostic Utility of QuantiFERON-TB Gold (QFT-G) in Active Pulmonary Tuberculosis. J Glob Infect Dis. 2015;7(3):108-12.

Chatterji S, Schmid ML, Anderson K, Oppong KW. Tuberculosis and the pancreas: a diagnostic challenge solved by endoscopic ultrasound. A case series. J Gastrointest Liver Dis. 2012;21(1):105-7.

Kaushik N, Schoedel K, McGrath K. Isolated pancreatic tuberculosis diagnosed by endoscopic ultrasound-guided fine needle aspiration: a case report. JOP. 2006;7(2):205-10.

Song TJ, Lee SS, Park DH, Lee TY, Lee SO, Seo DW et al. Yield of EUS-guided FNA on the diagnosis of pancreatic/peripancreatic tuberculosis. Gastrointest Endosc. 2009;69(3pt1):484-91.

Gan HT, Chen YQ, Ouyang Q, Hong B, Yang XY. Differentiation between intestinal tuberculosis and Crohn’s disease in endoscopic biopsy specimens by polymerase chain reaction. Am J Gastroenterol. 2002;97(6):1446-51.

Salahuddin A, Saif MW. Pancreatic tuberculosis or autoimmune pancreatitis. Case Rep Med. 2014;2014:410142.

Franco-Parades C, Leonard M, Jurado R, Blumberg H, Smith RM. Tuberculosis of the pancreas: report of two cases and review of the literature. Am J Med Sci. 2002;323(1):54-8.

D’Cruz S, Sachdev A, Kaur L, Handa U, Bhalla A, Lehl SS. Fine needle aspiration diagnosis of isolated pancreatic tuberculosis. A case report and review of literature. JOP. 2003;4(4):158-62.

Nagar AM, Raut AA, Morani AC, Sanghvi DA, Desai CS, Thapar VB. Pancreatic tuberculosis: a clinical and imaging review of 32 cases. J Comput Assist Tomogr. 2009;33(1):136-41.

Xia F, Poon RT, Wang SG, Bie P, Huang X, Dong J. Tuberculosis of pancreas and peripancreatic lymph nodes in immunocompetent patients: experience from China. World J Gastroenterol. 2003;9(6):1361-4.

Woodfield JC, Windsor JA, Godfrey CC, Orr DA, Officer NM. Diagnosis and management of isolated pancreatic tuberculosis: recent experience and literature review. ANZ J Surg. 2004;74(5):368-71.

Chaudhary P. Hepatobiliary tuberculosis. Ann Gastroenterol. 2014;27(3):207-11.






Case Reports