ArticleBMC infectious diseases2025
A case report of pancreatic tuberculosis: arterial infusion of isoniazid as an adjunct to oral antituberculosis medications has demonstrated promising therapeutic efficacy.
Article in BMC infectious diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundIsolated pancreatic tuberculosis is a rare manifestation of Mycobacterium tuberculosis infection in the human body. CASE PRESENTATION: A 35-year-old male presented at our medical center with upper abdominal distension and pain. Pre- and post-admission Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) scans revealed a pronounced ring-enhanced mass at the head of the pancreas, compressing the adjacent common bile duct. Initially, the radiologist misdiagnosed the mass as a pancreatic neuroendocrine tumor. The patient had no known history of tuberculosis exposure, and the tuberculin skin test demonstrated a positive result. The lesion was ultimately identified as a pancreatic tuberculous granuloma through endoscopic ultrasound-guided fine needle aspiration. Given the granuloma's rich arterial blood supply, we performed artery cannulation and locally infused isoniazid to reduce the patient's abdominal pain. The patient then began antitubercular therapy (ATT) The patient's epigastric pain resolved within 3 days post-regional arterial infusion (RAI), with no subsequent discomfort reported during follow-up. Subsequent evaluations at 4, 7, and 13 months demonstrated progressive lesion reduction. Three consecutive sputum smear tests (performed at intervals exceeding 6 months) yielded negative results for acid-fast bacilli, after which antituberculosis medications were discontinued per World Health Organization (WHO) criteria.
conclusionThis case demonstrates the complete diagnostic and therapeutic process of an isolated pancreatic tuberculosis patient. Through the combination of RAI and oral anti-tuberculosis medications, rapid symptom relief was achieved with favorable therapeutic outcomes. We share this experience to provide a reference for the treatment of such rare cases.
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