Pancreatic Tuberculosis: Resolution of Pancreatic Pseudocyst and Loculated Ascites Under Tuberculosis Therapy

Pancreatic tuberculosis is a rare disease. It mimics both benign and malignant conditions of the pancreas. We describe the case of a man who presented with repetitive epigastric pain and elevated pancreatic enzymes, leading to a presumptive diagnosis of alcohol-induced pancreatitis. Imaging revealed pancreatic pseudocyst, omental thickening, multiple loculated ascites, and bilateral pleural effusions. Despite supportive management for pancreatitis, the patient's symptoms worsened. Further evaluation raised the suspicion of tuberculosis. He was started on antituberculosis therapy. There was complete resolution of his symptoms, pseudocyst and ascites on follow-up imaging. Early suspicion and management of pancreatic tuberculosis may lead to excellent outcomes.