Tuberculosis of the pancreas: risks and recovery prospects

Typically the pathogen enters this organ through the blood of the already existing tuberculous lesions. Therefore tuberculosis of the pancreas are regarded as a secondary pathology – such, which is formed due to the lesions mentioned by the pathogen to other organs and tissues (most often the lungs). The primary pathology is quite rare.

Tuberculosis of the pancreas is called the disease with Mycobacterium tuberculosis.

The disease eventually leads to the fact that the pancreas stops functioning. Given the important role of glands in digestive health and support hormonal balance of the body, its tuberculous lesions should be regarded as a serious disease with irreversible consequences.

Patients with tuberculosis of the pancreas supervised by a tuberculosis specialist and gastroenterologist (or therapist).


Mycobacterium tuberculosis (tubercle Bacillus, Mycobacterium tuberculosis) are the only direct cause of the described disease.

Tuberculosis is generally regarded as a social disease – this applies to tuberculosis of the pancreas. Against the background of deteriorating living conditions that drain the human body, the tubercle Bacillus begins to act more actively.

It is noticed that tuberculosis of the pancreas (and, incidentally, tuberculous lesions of other organs and tissues) often occurs in socially disadvantaged segments of the population with such conditions of residence as:

  • poor diet – insufficient food, poor in carbohydrates, proteins, fats, vitamins, mineral elements, food;
  • humidity and drafts in the housing;
  • chronic fatigue;
  • chronic lack of sleep;
  • hard physical labor

and some others.

Tubercular lesions of the pancreas are more prone to disadvantaged segments of the population – prisoners, people without a certain residence and so on.

In addition, allocate a whole number of other factors that also contribute to the development of tuberculosis of the pancreas.

They can be divided into groups of factors:

  • inflammatory;
  • physical;
  • somatic;
  • endocrine;
  • toxic;
  • alimentary (food);
  • immunodeficiency;
  • malformations of the body.

Any inflammatory process of the pancreas is able to accelerate the development of tuberculous lesions. This, in particular:

  • pancreatitis – inflammation of the parenchyma of the pancreas;
  • inflammatory lose its ducts with subsequent generalization (broader distribution) of the pathological process.

Physical factors that can contribute to the development of the described diseases, in turn, are divided into:

  • traumatic;
  • radiation;
  • temperature.

Traumatic injury of the pancreas, in which tuberculous lesions come over “willingly”, there is in force:

  • wounds;
  • damage medical.

To the first belong any wounds:

  • closed – damage to the tissues of the pancreas that occurs without violation of integrity of its capsule;
  • open – communicating with the external environment. It bitten, torn, chipped, incised, and gunshot wounds.

Injury to the pancreas of a medical nature, contributing to the development of tuberculous lesions, occur during abdominal operations – not only in pancreas but also in the organs and tissues that reside nearby.

Most often it is operations:

  • the anastomosis (artificial reports) pancreatic duct with the intestine;
  • to remove the sequestrum (foci of necrosis) gland

and others.

Radiation damage of the pancreas can occur in such circumstances as:

  • radiation therapy for cancer of various organs and tissues;
  • contact with radioactive substances due to their professional activities;
  • contact with these substances for unauthorized access to them.

To weaken the defenses and facilitate the development of tuberculous process have value too high and too low temperature.

Somatic pathology contributing to the development of tuberculosis of the pancreas is:

  • disease the gland itself;
  • diseases and pathological conditions of other organs often protracted.

In the first case it often:

  • chronic pancreatitis – long current inflammatory lesion of the glands with periodic exacerbations;
  • acute suppurative pancreatitis – inflammatory space-occupying lesion of the gland or the entire body;
  • pancreatic necrosis, acute necrosis of the gland against the background of significant violations of the principles of healthy eating

and others.

Diseases of other organs that drain the body’s reserve, and thus contribute to the enhancement of Koch’s Bacillus is:

  • coronary heart disease (CHD) is a narrowing of the coronary artery followed by hypoxia (lack of oxygen) to the myocardium (heart muscle);
  • peptic ulcer and 12 duodenal ulcer – formation of deep defect in the wall of the stomach or duodenum 12;
  • chronic calculous cholecystitis – inflammation of gallbladder the presence of stones;
  • hepatitis and gepatozy different origin, respectively in inflammatory and non-inflammatory lesions of the liver.

From somatic factors distinguish the depletion of body resources in the background:

  • severe injuries;
  • extensive abdominal operations, in particular on the abdominal organs and thorax;
  • critical state (e.g., coma).

Endocrine pathology lead to failure of hormonal regulation of organs and systems – in particular, the pancreas, thus disrupting the normal processes in its tissues, which is also a factor contributing to the enhancement of Mycobacterium tuberculosis.

This, in the first place:

  • diabetes mellitus – lack of insulin, which results in a violation of carbohydrate metabolism;
  • hypothyroidism – not enough thyroid hormone in the body;
  • hyperthyroidism – excess thyroid hormones;
  • malfunction of the adrenal cortex with the subsequent failure on the part of corticosteroids

and some others.

Toxic damage of the pancreas, contributing to the reduction of resistance of its tissues to the tubercle Bacillus in the first place, develops on the background of such conditions and circumstances, such as:

  • contact with toxic substances in labor force activities. Is benzol, toluol, nitrates, nitrites, formaldehyde and many other aggressive compounds;
  • poisoning of the body due to uncontrolled intake of various medications;
  • infectious diseases, accompanied by massive decay of dead pathogens and the ingress of decomposition products in the blood.

Nutritional factors deteriorating the condition of the pancreas with increased susceptibility to the action of Mycobacterium tuberculosis, is the food:

  • bold;
  • fried;
  • smoked;
  • spicy.

One of the more alcohol poisoning. It can develop on the background of use:

  • large quantities of alcohol;
  • low-quality alcoholic drinks made in the handicraft way.

The causative agent of tuberculosis affects the pancreas on the background of deterioration in the local and General immunity. Most often this occurs in the following cases:

  • the defeat of HIV infection;
  • treatment with immunosuppressive drugs – medicines that are deliberately used to suppress the immune system for therapeutic purposes (e.g., after organ transplantation that the body did not reject the transplanted organ).

Malformations of the pancreas, indirectly contributing to the development of the tuberculous process is often:

  • a ring-shaped iron;
  • hypoplasia (underdevelopment);
  • splitting;
  • obstruction (clogging) of output ducts

and others.

The development of the pathology

Tuberculosis of the pancreas is a typical infectious-inflammatory process.

It looks like this:

  • Mycobacterium tuberculosis get with the flow of blood in the tissue of the pancreas;
  • some time they adapt, then begin to proliferate, their number increases;
  • the causative agent of destructive acts on the pancreas is in the first place, the products of vital activity and decay of dead microbial bodies act as toxins on breast tissue;
  • there are lesions and nonspecific reactive inflammatory response of the parenchyma of the gland to the effects – edema, hyperemia (redness), impaired functions;
  • with involvement of most or all tissues of a gland in the pathological process they become incapacitated, “turned off” because of the work glands, it ceases to function normally.
Symptoms of TB of the pancreas

Tuberculosis of the pancreas can occur in the form of options such as:

  • asymptomatic;
  • latent period (masking symptoms symptoms of pulmonary tuberculosis, which developed tuberculous lesions of the pancreas);
  • for with severe symptoms.

In the latter case, for tuberculosis of the pancreas secrete several syndromes (symptom):

  • abdominal;
  • infectious;
  • exocrine insufficiency;
  • endocrine failure.

Abdominal syndrome is manifested by pain. Their characteristics:

  • localization in the upper abdomen, mostly in left upper quadrant;
  • distribution radiating (give) back;
  • by nature nouse-pressing;
  • for intensity – medium intensity, tolerated;
  • in appearance – begins to form with the onset of the disease, then are almost constant in nature, periodically amplified.

Infectious syndrome is a manifestation of infectious-inflammatory process in the pancreas, triggered by Mycobacterium tuberculosis.

It manifests itself with symptoms such as:

  • hyperthermia (increased body temperature). It often reaches up to 37,3-37,5 degrees Celsius. With the progression of the disease described can be observed febrile state at the same time observed chills and hyperthermia to 38.0-38.5 degrees Celsius;
  • weakness;
  • excessive sweating.

Exocrine insufficiency means the violation of the synthesis (production) of digestive enzymes by the pancreas.

Its manifestations are the following:

  • bitterness in the mouth;
  • belching with an unpleasant taste;
  • nausea;
  • vomiting of undigested food;
  • poor appetite, often – complete lack;
  • weight loss;
  • a feeling of heaviness in the abdomen;
  • politically – the patient is recovering a large volume of feces;
  • change in stool – they are either light or very dark color may also be observed steatorrhea – fatty stool;
  • diarrhea (diarrhea) – frequent loose stools.

Endocrine insufficiency means a reduction in the production of insulin, which is responsible for regulating the amount of sugar in the blood. Its signs are:

Diagnosis of tuberculosis of the pancreas

The initial diagnosis of tuberculosis of the pancreas is based on the patient’s complaints and data of anamnesis.

From anamnestic data of great importance are diagnosed with tuberculosis of other organs and complex social conditions.

Significant is the deterioration of the General condition of the patient, his weight loss, hyperthermia, weakness, sweating.

The diagnosis is confirmed using additional methods of examination – physical, instrumental, laboratory.

Results of physical examination:

  • on examination – the patient is emaciated, sometimes to the point of “skin and bones” skin and visible mucous membranes are pale;
  • palpation (feeling) of the abdomen is determined by tenderness in the left hypochondrium;
  • auscultation of the abdomen (listening foetoscope) – in the presence of diarrhea may be intensified peristalsis.

Instrumental methods of research, which attract in the diagnosis of tuberculosis of the pancreas is:

  • ultrasound examination of the pancreas (ultrasound) – ultrasound assisted assessment of its size, location, structure, condition of the ducts of the prostate, detect concretions (stones) and foci of tuberculous lesions;
  • fibrobroncoscopia – study mucosal 12 duodenal ulcer with an endoscope. When you do this, assess the condition of the mouth (opening) of the duct of the pancreas in 12-duodenum, the condition of the mucous membrane;
  • retrograde cholangiopancreatography – performing a series of x-ray images of the pancreas after the administration in its flow of contrast medium through a probe immersed in the 12-duodenum. Using images to assess the condition of the ductless glands, and also the state of the biliary system;
  • magnetic resonance imaging (MRI) is one of the most informative methods of diagnosis, as it helps to evaluate in detail the structure of the tissues of the gland. In this case it is used to assess the condition of the tissues of the pancreas, permeability and structure of its excretory duct;
  • magnetic resonance cholangiopancreatography (MRCP) – MRI study after the introduction of contrast agent into the pancreatic duct and the common bile duct. Helps to assess the degree of permeability and structure of these ducts;
  • chest x-ray – x-ray of the chest to detect tuberculosis lesions. This is a mandatory method in cases of suspected tuberculosis of the pancreas.

Laboratory methods used in the diagnosis of the described diseases, the following:

  • General analysis of blood – determined by non-specific signs of inflammation, namely an increased number of leukocytes (leukocytosis) with a shift of leukocyte formula to the left and increased ESR;
  • biochemical analysis of blood to determine the level of enzymes that will help to evaluate the work of the pancreas and the amount of protein in the blood (it is reduced);
  • a stool sample – it reveals the particles of fat and undigested fiber, which indicates incomplete digestion due to insufficient synthesis of digestive enzymes produced by the pancreas;
  • tuberculin test (Mantoux test) is used to confirm the diagnosis of tuberculosis. The patient under the skin injected tuberculin is a mixture of filtrates of cultures of Mycobacterium tuberculosis, heat-killed and treated with certain chemicals. Forms a papule (bump), after a certain time after the injection of tuberculin assess its characteristics (size, color) which make the conclusion about the development in the organism of tuberculosis.
Differential diagnosis of

Differential diagnosis of tuberculosis of the pancreas is often carried out with such pathologies as:

  • chronic pancreatitis;
  • chronic cholecystitis – chronic inflammatory process in the gallbladder;
  • chronic cholangitis – inflammation of the bile ducts.

The most frequent complications of tuberculosis of the pancreas are:

  • violation of the digestive processes;
  • violation of the synthesis of insulin;
  • suppuration of tubercular foci;
  • necrotization (necrosis) tuberculosis foci;
  • tuberculous peritonitis – inflammation of the sheets of the peritoneum;
  • reactive cholangitis;
  • hypovitaminosis – lack of vitamins (especially A, D, E, K);
  • diabetes.
Treatment of tuberculosis of the pancreas

Treatment of tuberculosis of the pancreas is a conservative. It requires long time and patience from both the patient and the doctor. Important are:

  • a special diet;
  • medication.

If a patient has active tuberculosis of the lungs, resulting in tuberculous lesions of the pancreas, treatment should be held in the tuberculosis dispensary.

Power specifications the following:

  • the high content in the diet of easily digestible protein. It’s chicken, veal, rabbit meat and turkeys, lean fish (river and sea);
  • the high content of fiber. It contains a large number of fresh and cooked fruits and vegetables, whole wheat bread, cereals;
  • limit the consumption of fat, and even better – the rejection of them with rare use only in order to vary the diet. First and foremost, this applies to the animal fats – fatty meats, butter, sour cream;
  • limit dishes that stimulate the secretion of digestive juices – fatty, fried, smoked, spicy;
  • avoiding alcohol, strong coffee, sparkling water.

Drug therapy includes the use of such groups of drugs as:

  • anti-TB means;
  • food enzymes;
  • drugs that regulate the level of sugar in the blood.

Practiced appointment of combinations of anti-TB drugs under the regular supervision of a physician. They are used strictly according to the scheme prescribed by the doctor for at least 6 months.

Digestive enzymes prescribed with the aim of substitution for regulation of digestion.

Substitution treatment in the endocrine disorders of the pancreas performed using drugs that reduce blood sugar levels. If necessary, the issue of the appointment of insulin.


The basis of prevention of tuberculosis of the pancreas are the General principles of prevention of tuberculous lesions of any location. It is very important to improve the social level of the person who possesses all the prerequisites to develop TB disease – poor nutrition, poor living conditions, overwork, heavy physical labor (especially with the lack of the body, and on the background of poor nutrition) and so on.

The risk of TB can be reduced by such measures and actions as:

  • complete and balanced nutrition, the ingestion of sufficient amounts of fat, protein, carbs, vitamins, mineral substances;
  • the refusal from the diet, limiting the intake of enough calories, the people who complain of fatigue, housed in substandard conditions;
  • avoiding harmful habits;
  • strengthening the immune system – first of all, using these simple and affordable techniques, such as hardening, physical education;
  • avoidance of chronic fatigue;
  • observance of rules of personal hygiene – particularly after visits to places of a mass congestion of people, because of the probability of contact with patients suffering from open form of tuberculosis are still not diagnosed;
  • healthy lifestyle as a whole – adherence to work, rest, sleep.

The prognosis of tuberculosis of the pancreas is often difficult. This organ is highly sensitive to the action of pathogenic factors, particularly infectious. Also, be aware that pathology develops in the presence of tuberculous lesions of other organs and tissues, which provokes a weakening of the protective forces of the body.

From tuberculosis of the pancreas can be removed only if appointed in a timely competent treatment, and the patient strictly fulfills all the requirements of a doctor.

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