Hickey N, McNulty J G, Osborne H, Finucane J
Department of Radiology, Beaumont Hospital, Dublin 9, Ireland.
Eur Radiol. 1999;9(5):886-9. doi: 10.1007/s003300050761.
Two cases of hepatobiliary tuberculosis are described. Case one, the macronodular type of hepatic tuberculosis, presented as pyrexia of unknown origin and was eventually diagnosed by sectional imaging when a mass lesion developed in the liver and aspiration revealed acid-fast bacilli. Case two presented with jaundice due to a hilar bile duct stricture. The patient was successfully treated by repeated bile duct stenting and later chemotherapy for tuberculosis. In both cases previous positive histology or culture would have expedited diagnosis and treatment. Acute hepatobiliary tuberculosis remains a rare disease. Suspicion of the disease and adequate biopsy are important to allow prompt appropriate treatment.
本文描述了两例肝胆结核病例。病例一为肝结核的大结节型，最初表现为不明原因发热，当肝脏出现肿块病变且穿刺发现抗酸杆菌后，最终通过断层成像得以确诊。病例二则因肝门部胆管狭窄出现黄疸。该患者通过反复胆管支架置入及后续抗结核化疗成功治愈。在这两例病例中，若之前有阳性组织学检查结果或培养结果，本可加快诊断和治疗进程。急性肝胆结核仍然是一种罕见疾病。怀疑该病并进行充分活检对于及时进行恰当治疗很重要。
