General Medicine, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India.
Critical Care Medicine, St John's Medical College Hospital, Bangalore, Karnataka, India.
BMJ Case Rep. 2022 Nov 4;15(11):e252511. doi: 10.1136/bcr-2022-252511.
Hepatobiliary tuberculosis is a rare condition causing obstructive jaundice either by enlarged lymph nodes around the bile ducts or involvement of biliary epithelium by the tuberculous process. Since a tissue diagnosis is not mandatory to proceed with the resection or initiation of a liver transplant protocol, benign lesions are occasionally misdiagnosed as hilar cholangiocarcinoma. Here, we present a case of hepatobiliary tuberculosis which presented as obstructive jaundice due to hilar obstruction. The mass causing the obstruction was then later found to be a pseudotumour, typical of tuberculosis. This diagnosis meant that extensive surgical resection as a protocol for cholangiocarcinoma was avoided. The patient recovered completely after a course of antitubercular therapy.
肝胆结核是一种罕见的疾病,可导致胆管周围淋巴结肿大或结核过程累及胆管上皮,从而引起阻塞性黄疸。由于进行切除或启动肝移植方案并不一定需要组织学诊断,因此良性病变偶尔会被误诊为肝门部胆管癌。在这里,我们报告了一例肝胆结核病例,其表现为肝门部阻塞引起的阻塞性黄疸。导致阻塞的肿块后来被发现是一个典型的结核性假肿瘤。这一诊断意味着避免了广泛的手术切除作为胆管癌的治疗方案。患者在接受抗结核治疗后完全康复。