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- W4312341421 abstract "Obstructive jaundice rare variant caused by abdominal tuberculosis specially due to involvement of peripotal lymph node. Abdominal tuberculosis (TB) commonly affects the intestinal tract, lymph nodes, peritoneum and solid organs in varying combinations. I will describe a patient with biliary obstruction caused by enlarged tubercular lymph nodes. Introduction: Mr. Milon age 22 years develops jaundice 1 month back.Mild fever. Apetite good. Liver function test Bilirubin level 10.4gm/dl, SGPT/ALT 214.6 u/L, Alkaline phosphatase 808 U/L. Serum creatinine 0.50 mg/dl. Viral profile HBsAg negative, HCV antiboby negative.prothrombine time 14.0 seconds. Concentration of CA 19-9 is 53.7 U/Ml. Ultrasonography finding reveal common bile duct mildly dilated (19mm). No lymphadenopathy. CT scan whole abdomen with contrast findings revealed intrahepatic bile duct dilatation, The common bile duct measures upto 18 mm diameter and abruptly narrowes at superior margin of the head of pancreas.Gall bladder distended in size with lumen full of sludge. MRCP impression Distal cholangiocarcinoma/extrahepatic cholangiocarcinoma in CBD at the level of superior margin of the head of pancreas. Operative decision was whipples procedure. After laparotomy detected enlarge periportal lymphnodes send for frozen biopsy revealed casaeating necrosis confirm granulomatous tubercular lymphadenitis. Choledochoduodenostomy done for lowering of obstructive features. Discussion: Hepatobiliary tuberculosis difficult to diagnose.The annual incidence of hepatobiliary TB reported as 1.05% of all TB infections. Abdominal tuberculosis causes obstructive jaundice by mechanical obstruction of the biliary tract. Obstructive jaundice secondary to tubercular lymphadenitis can be confused with hepatobiliary malignancy. Antitubercular drugs started after immediate postoperative period. Conclusion: Though rare disease. Diagnosis at operative field change the decision of major surgery." @default.
- W4312341421 created "2023-01-04" @default.
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- W4312341421 date "2022-01-01" @default.
- W4312341421 modified "2023-10-16" @default.
- W4312341421 title "Periampullary Tuberculosis-obstructive Jaundice - A Rare Case Report" @default.
- W4312341421 doi "https://doi.org/10.1016/j.hpb.2022.05.582" @default.
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