Chaudhary Poras
Department of Surgery, Dr Ram Manohar Lohia Hospital (Dr RMLH and PGIMER), New Delhi, India.
Ann Gastroenterol. 2014;27(3):207-211.
Hepatobiliary tuberculosis is a rare manifestation of infection and is usually secondary to tuberculosis of the lungs or gastrointestinal tract. Diagnosis is difficult pre-operatively in local (focal and tubular) forms because of its rarity and presentation in the form of non-specific symptoms and signs and lack of any defined criteria on imaging studies. Histopathological examination is necessary for definite diagnosis but in cases where there is suspicion of hepatobiliary tuberculosis, with PCR assay diagnosis it is possible pre-operatively. Recommended treatment is with conventional antituberculous drugs and surgical intervention in tuberculous abscess or granulomas. The disease is usually associated with good prognosis under complete antituberculous treatment. The author encountered 4 cases of hepatobiliary tuberculosis over 5 years. The aim of this article is to present current knowledge of hepatobiliary tuberculosis and to comprehensively review all the available literature.
肝胆结核是一种罕见的感染表现形式,通常继发于肺部或胃肠道结核。由于其罕见性、以非特异性症状和体征形式呈现以及影像学检查缺乏明确标准,术前诊断局部(局灶性和管状)形式的肝胆结核很困难。明确诊断需要组织病理学检查,但在怀疑有肝胆结核的病例中,通过聚合酶链反应(PCR)检测有可能在术前做出诊断。推荐的治疗方法是使用传统抗结核药物,并对结核性脓肿或肉芽肿进行手术干预。在全程抗结核治疗下,该病通常预后良好。作者在5年中遇到了4例肝胆结核病例。本文的目的是介绍肝胆结核的当前知识,并全面回顾所有可用文献。