胰腺结核的诊断与治疗

Diagnosis and treatment of pancreatic tuberculosis

胰腺结核是胰腺慢性特异性感染性疾病,临床罕见,常继发于常见部位的结核.胰腺结核起病隐匿,无特异性症状,漏诊、误诊率高.2014年6月郑州大学第一附属医院收治1例胰腺结核患者,术前影像学检查示胰头部占位性病变,考虑胰腺癌.术中探查见胰头部占位侵犯胆囊管,快速冷冻切片活组织病理学检查示肉芽肿性炎,倾向结核,行肉芽肿切除＋胆囊切除术.术后病理学检查结果与术中一致.患者出院后予保肝、抗结核治疗.

Pancreatic tuberculosis （PTB） is a rare,chronic,specific and infectious disease which is generally secondary to tuberculosis at the common sites of pancreas,and it has a high misdiagnosis rate due to the hidden onset and nonspecific symptoms of PTB.A patient with PTB was admitted to the First Affiliated Hospital of Zhengzhou University in June 2014.Before operation,the space-occupying lesions of the head of pancreas were detected by preoperative imaging examination,and the patient was regarded as with pancreatic cancer.Intraoperative exploration showed cystic duct involvement,and the granulomatous inflammation was detected by rapid pathological examination using frozen section technique,after that the patient received granuloma resection＋cholecystectomy according to suspected PTB.The diagnosis of PTB was confirmed by postoperative pathological examination,and the patient received liver-protective and anti-tuberculosis treatments after discharge.