Abstract
BackgroundHepatobiliary tuberculosis is a rare manifestation of Mycobacterium tuberculosis infection, especially in younger patients. The non-specific symptoms and signs as well as the lack of definite imaging characteristics often impedes diagnosis. Definite diagnosis of tuberculosiscan be obtained through histopathological examination; conventional anti-tuberculosis drugs and surgery are the most commonly recommended treatments.Case presentationA previously healthy 15-year-old rural adolescent male presented with a 2-month history of weight loss and fatigue. We strongly suspected a Klatskin tumor; therefore, exploratory laparotomy was performed. However, the microscopical findings revealed a granuloma consisting of epithelioid cells, caseous necrosis, and lymphocytic infiltration, indicating caseating granulomatous inflammation and yielding a final diagnosis of hepatic hilar tuberculosis.ConclusionHepatic hilar tuberculosis is an extremely rare case; few physicians may have actually treated a case. This report therefore aims to improve the overall understanding of lymphatic tuberculosis of the hepatic hilum.
Highlights
Hepatobiliary tuberculosis is a rare manifestation of Mycobacterium tuberculosis infection, especially in younger patients
This report aims to improve the overall understanding of lymphatic tuberculosis of the hepatic hilum
Hepatobiliary tuberculosis is a rare type of Mycobacterium tuberculosis infection, especially in children and adolescents
Summary
Hepatobiliary tuberculosis is a rare type of Mycobacterium tuberculosis infection, especially in children and adolescents. The disease itself does not have any characteristic signs and symptoms; there are no defined characteristics in terms of imaging studies. Diagnosis of this specific condition is difficult. Histopathological examination is considered the gold standard for diagnosing this condition. Case presentation A previously healthy 15-year-old rural adolescent male presented with the symptoms of weight loss and fatigue since 2 months. The patient reported occasional discomfort in the right upper quadrant of the abdomen, a daily nocturnal low-grade fever (37.5–38.5 °C), and a weight loss of 3.5 kg, but there was no jaundice. Based on these results, we suspected a potential diagnosis of Klatskin tumor. Exploratory laparotomy was performed; diffuse small lesions were detected in the hepatic portal circulation, from the hepatic hilum to the middle of the common bile duct and surrounding
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