Introduction
Abdominal tuberculosis (TB) commonly affects the intestinal tract, lymph nodes, peritoneum, and solid organs in varying combinations. Up to two-thirds of patients with abdominal TB have abdominal lymphadenopathy or peritoneal disease in addition to intestinal involvement. One-third may have extra-intestinal involvement also (1). Isolated hepatobiliary or pancreatic and peripancreatic TB is rare, especially when present in immunocompetent hosts. It’s often occurring in the setting of miliary TB or widely disseminated disease (2). Pancreatic TB may present as a pancreatic abscess, acute or chronic pancreatitis, and cystic or solid pancreatic masses (2)(3). Clinically and radiologically pancreatic TB closely resembles a pancreatic malignancy. Therefore, most cases of pancreatic TB have been diagnosed after exploratory laparotomy surgery for suspected malignancy. However, with the use of improved imaging techniques computed tomography (CT) or more recently endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) and image-guided interventions preoperative diagnosis of pancreatic masses is now possible without going for surgery (2). EUS-guided fine-needle aspiration allows us not only to obtain tissue samples for PCR diagnosis but also to perform therapeutic aspiration of the abscess (4). Because of the non-specific clinical presentation, the disease can elude a diagnosis, but once diagnosed it responds favorably to anti-tuberculous therapies (ATT). The available literature related to hepatobiliary or pancreatic tuberculosis is mostly in the form of case reports or series. Therefore, we reported our experience with this rare form of abdominal TB, which presented with pancreatic and liver abscesses, finally diagnosed and confirmed through both radiological images and EUS-FNA.