Atypical hepatic tuberculosis presenting as obstructive jaundice.
A 78-yr-old female with a short history of malaise, anorexia, mild pyrexia, and obstructive jaundice is presented. A diagnosis of tuberculosis of the liver and gallbladder was established at laparotomy. In spite of anti-tuberculous therapy, the patient died on the 5th postoperative day. Widespread miliary tuberculosis affecting the lung, kidneys, spleen, and mesenteric lymph nodes was observed in postmortem studies, with strikingly severe involvement of the intrahepatic bile ducts. Saccular dilatation of the bile ducts alternating with areas of stenosis and narrowed intrahepatic bile ducts was seen. A correlation of the radiological and hepatic postmortem findings is discussed. The atypical presentation of tuberculosis in present times and the causes of jaundice in atypical cases of hepatic tuberculosis are discussed. The rarity of gallbladder tuberculosis is pointed out.
Abascal
J
J
Department of Surgery, Medical School, Universidad Autonoma, Madrid, Spain.
Martin
F
F
Abreu
L
L
Pereira
F
F
Herrera
J
J
Ratia
T
T
Menendez
J
J
D000368:Aged; D001653:Bile Ducts, Intrahepatic / Q000000981:diagnostic imaging; D002763:Cholecystectomy; D002765:Cholecystography; D002779:Cholestasis / Q000000981:diagnostic imaging / Q000209:etiology*; D005260:Female; D006801:Humans; D011183:Postoperative Complications / Q000401:mortality; D018805:Sepsis / Q000401:mortality; D014386:Tuberculosis, Hepatic / Q000150:complications*