Hepatic tuberculosis: A report of two cases

Abstract

Hepatic tuberculosis is very rare, but may be detected during autopsy, laparoscopy, or abdominal exploration in patients with tuberculosis of the abdomen. The lesions produced are granulomas, large caseating lesion, a calcified mass, or biliary strictures. During the last 10 year period, 21 patients with abdominal tuberculosis were treated at Department of General Surgery, University of Çukurova, Turkey. Two (9 %) of them had hepatic tuberculosis. They presented with jaundice and elevated alkaline phosphatase levels due to periportal lymph node compression to the bile duct. Abdominal ultrasonography and computed tomography showed perihilar lymphadenopathy in one of them and cytic mass in the right anterior lobe of the liver in the other. At laparatomy, liver biopsy showed characteristic features of tuberculosis of the liver. Anti-tuberculotic drug regimen was given (except ethambutol) for 8 months. The cases were carefully assessed during the associated with plastic adhesions and development of enterocutaneous fistulas, but recovered after 3 months. No reoperation required. The other had uneventful recovery.