Esguerra-Paculan Ma Jenina Angela, Soldera Jonathan
Acute Medicine, University of South Wales, Cardiff CF37 1DL, United Kingdom.
World J Gastrointest Surg. 2023 Oct 27;15(10):2305-2319. doi: 10.4240/wjgs.v15.i10.2305.
Hepatobiliary tuberculosis is a challenging disease that poses diagnostic difficulties due to its resemblance to other etiologies. Delayed diagnosis may lead to inadequate treatment, thus necessitating an urgent need for accurate diagnosis and appropriate management.
To systematically review case reports on hepatobiliary tuberculosis, focusing on symptomatology, diagnostic procedures, management, and outcomes to provide patient safety and ensure an uneventful recovery.
A systematic search was conducted on PubMed from 1992 to 2022, using keywords such as hepatobiliary, liver, tuberculosis cholangitis, cholangiopathy, and mycobacterium. Only case reports or case series in English were included in the study, and research papers published as abstracts were excluded. The search yielded a total of 132 cases, which were further narrowed down to 17 case studies, consisting of 24 cases of hepatobiliary tuberculosis.
The 10 most common symptoms observed in these cases were fever, abdominal pain, weight loss, jaundice, anorexia, generalized weakness, pruritus, chills, fatigue, and chest pains. Objective findings in these cases included hepatomegaly, hepatic nodules, elevated liver enzymes, and elevated bilirubin. Computed tomography scan and ultrasound of the abdomen were the most useful diagnostic tools reported. Histologic demonstration of confirmed the cases of hepatobiliary tuberculosis. Treatment regimens commonly used included Rifampicin, Isoniazid, Pyrazinamide, and Ethambutol. Out of the 24 cases, 18 presented improvements while 4 had completely recovered.
Hepatobiliary tuberculosis is a disease that requires accurate diagnosis and appropriate management to avoid complications.
肝胆结核是一种具有挑战性的疾病，因其与其他病因相似而导致诊断困难。延迟诊断可能导致治疗不充分，因此迫切需要准确诊断和适当管理。
系统回顾肝胆结核的病例报告，重点关注症状、诊断程序、管理和结果，以保障患者安全并确保顺利康复。
于1992年至2022年在PubMed上进行系统检索，使用“肝胆”“肝脏”“结核性胆管炎”“胆管病”和“分枝杆菌”等关键词。该研究仅纳入英文的病例报告或病例系列，排除以摘要形式发表的研究论文。检索共得到132例病例，进一步筛选后得到17项病例研究，其中包括24例肝胆结核病例。
这些病例中观察到的10种最常见症状为发热、腹痛、体重减轻、黄疸、厌食、全身无力、瘙痒、寒战、疲劳和胸痛。这些病例的客观检查结果包括肝肿大、肝结节、肝酶升高和胆红素升高。计算机断层扫描和腹部超声是报告中最有用的诊断工具。组织学证实了肝胆结核病例。常用的治疗方案包括利福平、异烟肼、吡嗪酰胺和乙胺丁醇。在这24例病例中，18例病情有所改善，4例已完全康复。
肝胆结核是一种需要准确诊断和适当管理以避免并发症的疾病。
