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Atypical hepatic tuberculosis presenting as obstructive jaundice.

J Abascal1, F Martin, L Abreu

  • 1Department of Surgery, Medical School, Universidad Autonoma, Madrid, Spain.

The American Journal of Gastroenterology
|October 1, 1988
PubMed
Summary

This case study highlights a rare instance of tuberculosis affecting the liver and gallbladder, leading to obstructive jaundice. Despite treatment, the patient

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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Pathology

Background:

  • Tuberculosis (TB) can present atypically in immunocompetent individuals.
  • Obstructive jaundice is an uncommon manifestation of hepatic tuberculosis.

Observation:

  • A 78-year-old female presented with malaise, anorexia, mild fever, and obstructive jaundice.
  • Laparotomy confirmed tuberculosis of the liver and gallbladder.
  • Postmortem examination revealed widespread miliary tuberculosis, with severe intrahepatic bile duct involvement.

Findings:

  • The intrahepatic bile ducts showed saccular dilatation alternating with stenosis.
  • Radiological and postmortem findings correlated, indicating severe hepatic TB.
  • Gallbladder tuberculosis is exceptionally rare, contributing to atypical presentations.

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Implications:

  • This case underscores the importance of considering tuberculosis in the differential diagnosis of obstructive jaundice, even with atypical presentations.
  • Understanding the varied manifestations of hepatic tuberculosis is crucial for timely diagnosis and management.
  • Further research into the pathogenesis of gallbladder tuberculosis may elucidate its rarity and clinical significance.