Abdominal infection with tuberculosis commonly affects the spleen, liver, ileocecal region and peritoneum. Tuberculosis of the pancreas is considered a rare entity in developed countries, occurring mostly in thesetting of HIV infection or immunosuppression for transplantation. Nevertheless, there has been an increase in the number of cases reported involving immunocompetent patients, originating mostly from developing countries. In a large portion of these cases, there is neither concomitant disease elsewhere nor evidence of miliary dissemination. The pathogenesis of pancreatic tuberculosis remains speculative and may involve: 1) pancreatic involvement during miliary disease, 2) hematogenous dissemination froman occult site elsewhere (possibly the lungs) and 3) direct spread from contiguous lymph nodes. In support of the last theory, in most of the cases with perceived isolated pancreatic tuberculosis (such as in our patient), there is radiographic and/or histopathologic evidence of regional lymph node involvement.
Last date updated on July, 2014