Pancreas Ultrasound Finding among Abdominal Tuberculosis with Dyspeptic Syndrome

Abstract

Dyspeptic syndrome is common in patients with abdominal tuberculosis. These complaints are often difficult at the time of taking the multidrugs anti-tuberculosis, especially in intensive phase of the treatment.The objective of this study was to describe pancreas ultrasound finding among abdominal tuberculosis with dyspeptic syndrome. This study was conducted at Emma Poeradiredja Hospital Bandung from August,1st 2008 to December, 15th 2011. Pancreas of abdominal tuberculosis patients were examined by a certified ultrasound internal medicine specialist with trans-abdominal ALOKA-Prosound SSD3500. There were 178 abdominal tuberculosis (including peritoneal and small bolwe tuberculosis and urinary track tuberculosis) patients. 146(82%) with mild dyspeptic syndrome with recurrent epigastric pain, mild nausea, abdominal distension, mild malabsorption without underweight. Ultrasound of pancreas showed heterogenous hyperechoic pancreatic lesion with irregular pancreatic margin, focal/segmental hyperechoic lesion in addition of some irregular oval/round lesions (patchy hyperechoic non-shadowing with an irregular rim of lower echodensity) with normal pancreas size. Otherwise 32(18%) patients with severe dyspeptic syndrome with chronic recurrent bouts epigastric pain radiating to the back, anorexia, nausea, vomiting, chronic diarrhoea with obviously malabsorption and underweight; these patients had diffuse hyperechoic lesion with or without calcification and decreased of pancreas size. Severity of pancreatic ultrasound finding were corresponding with severity of dyspeptic syndrome among abdominal tuberculosis.