Pancreatic tuberculosis presenting as gastric outlet obstruction: a case report

Abstract

Pancreatic tuberculosis is an uncommon yet significant condition that can mimic malignant diseases, leading to challenges in diagnosis and management.​ It can present as gastric outlet obstruction due to swelling and inflammation, extrinsic compression, fibrosis and stricture formation. In such scenarios diagnosis of pancreatic tuberculosis should be considered especially in areas with high prevalence of tuberculosis. This case report presents a 68-year-old male exhibiting atypical symptoms of gastric outlet obstruction. Initial assessment suggested a potential malignancy, as imaging revealed a mass and laboratory tests showed abnormalities (anemia, raised erythrocyte sedimentation rate and C-reactive protein), prompting concerns about a pancreatic neoplasm. The patient had to undergo an exploratory laparotomy and subsequent histopathological examination of the pancreatic mass revealed noncaseating granulomas indicative of pancreatic tuberculosis instead of a malignancy. This case highlights the need to consider tuberculosis in gastric outlet obstruction, as its presentation often mimics malignancy. Early diagnosis prevents unnecessary interventions and ensures excellent treatment outcomes as patients responded well to appropriate treatment and recovered completely.