title: Tuberculous lymphadenitis as a cause of obstructive jaundice.
abstract: Obstructive jaundice secondary to abdominal tuberculosis is extremely rare. We present a patient with jaundice secondary to compression of the common bile duct by TB lymphadenitis. A 49-year-old woman was admitted to our department for nausea,epigastric pain and jaundice. Abdominal ultrasonography and computer tomography scan were suggestive of stenosis of the distal common bile duct caused by a retro pancreatic mass. At laparotomy, an enlarged lymph node behind the head of the pancreas was found, causing compression and stenosis of the distal parts of the choledochus. The lymph node frozen section analysis showed epithelioid granuloma with caseous necrosis,strongly suggesting tuberculous origin. Choledochoduodenal anastomosis was performed. Definitive pathohistological examination confirmed TB lymphadenitis. ATB should be considered as a potential cause of jaundice especially in immuno compromised patients and endemic areas. Diagnosing abdominal tuberculosis can be a challenging task. No satisfactory diagnostic gold standard is available so that in most cases the diagnosis cannot be reached before exploratory laparotomy.Early detection enables successful conservative treatment and eliminates the necessity of surgery.
authors.forename: L
authors.initials: L
authors.lastname: Jeremic
authors.forename: M
authors.initials: M
authors.lastname: Stojanovic
authors.forename: M
authors.initials: M
authors.lastname: Radojkovic
authors.forename: A
authors.initials: A
authors.lastname: Zlatic
authors.forename: N
authors.initials: N
authors.lastname: Ignjatovic
authors.forename: S
authors.initials: S
authors.lastname: Jeremic
mesh_terms: D000714:Anastomosis, Surgical; D000995:Antitubercular Agents / Q000627:therapeutic use; D002763:Cholecystectomy; D003137:Common Bile Duct Diseases / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery; D003937:Diagnosis, Differential; D042241:Early Diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D041781:Jaundice, Obstructive / Q000000981:diagnostic imaging* / Q000209:etiology* / Q000601:surgery; D008875:Middle Aged; D014395:Peritonitis, Tuberculous / Q000150:complications*; D011859:Radiography; D016896:Treatment Outcome; D014388:Tuberculosis, Lymph Node / Q000150:complications* / Q000000981:diagnostic imaging* / Q000188:drug therapy / Q000382:microbiology / Q000601:surgery
chemical_list: D000995:Antitubercular Agents