关键词: 超声内镜, 胰腺结核, 细针穿刺活检术, 诊断, 鉴别诊断

Abstract: Objective To explore and understand the diagnosis，differential diagnosis，and treatment of pancreatic tuberculosis by reporting a case of a patient who presented to the hospital with belching and underwent endoscopic ultrasound-guided fine-needle aspiration biopsy（EUS-FNA），which was considered to be tuberculosis of the pancreatic head. Methods The case data and diagnostic process of a patient with pancreatic head tuberculosis were analyzed and discussed with the relevant literature. Results Through endoscopic ultrasound-guided fine-needle aspiration biopsy，the case was examined and subsequently confirmed to be pancreatic head tuberculosis after a consultative review with Wuhan Union Hospital. Clinical symptoms were alleviated after the initiation of anti-tubercular therapy， and the disappearance of the lesions was evident upon subsequent evaluation by color ultrasound of the liver，gallbladder，spleen，pancreas，both kidneys，and ureter，as well as abdominal CT. Conclusion Pancreatic tuberculosis is relatively rare，lacks specificity in clinical features and imaging manifestations，is difficult to diagnose，similar to pancreatic tumors，easy to misdiagnose and perform surgery. Pathological biopsy guided by ultrasonic endoscopy before surgery can greatly avoid trauma caused by surgery，help differential diagnosis，and obtain better therapeutic effects by further anti-tuberculosis treatment.

Key words: endoscopic ultrasonography, pancreatic tuberculosis, EUS-FNA, diagnosis, differential diagnosis