A case of obstructive jaundice caused by tuberculous lymphadenitis: A literature review
Korean Journal of Hepatology 2014³â 20±Ç 2È£ p.208 ~ p.213
¹é¼öÁ¤(Baik Su-Jung) - Yonsei University Gangnam Severance Hospital Department of Internal Medicine
À¯±Ç(Yoo Kwon) - Ewha Womans University School of Medicine Department of Internal Medicine
±èÅÂÈÆ(Kim Tae-Hun) - Ewha Womans University School of Medicine Department of Internal Medicine
¹®ÀÏȯ(Moon Il-Hwan) - Ewha Womans University School of Medicine Department of Internal Medicine
Á¶¹Î¼±(Cho Min-Sun) - Ewha Womans University School of Medicine Department of Pathology
Abstract
Obstructive jaundice caused by tuberculous lymphadenitis is a rare manifestation of tuberculosis (TB), with 15 cases having been reported in Korea. We experienced a case of obstructive jaundice caused by pericholedochal tuberculous lymphadenitis in a 30-year-old man. The patient¡¯s initial serum total bilirubin level was 21.1 mg/dL. Abdominal computed tomography revealed narrowing of the bile duct by a conglomerated soft-tissue mass involving the main portal vein. Abrupt obstruction of the common bile duct was observed on cholangiography. Pathologic analysis of a ultrasonographyguided biopsy sample revealed chronic granulomatous inflammation, and an endoscopic examination revealed esophageal varices and active duodenal ulceration, the pathology of which was chronic noncaseating granulomatous inflammation. Hepaticojejunostomy was performed and pathologic analysis of the conglomerated soft-tissue mass revealed chronic granulomatous inflammation with caseation of the lymph nodes. Tuberculous lymphadenitis should be considered in patients presenting with obstructive jaundice in an endemic area.
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Tuberculosis, Lymphadenitis, Portal hypertension
KMID :
1103920140200020208
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