Rare Diseases Symptoms Automatic Extraction
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Biliary tract tuberculosis--a diagnostic dilemma.
[carcinoma of the gallbladder]
Most
western
patients
who
have
not
had
a
previous
operation
and
present
with
biliary
obstruction
are
thought
to
have
a
malignant
lesion
.
However
in
our
country
where
the
disease
is
common
,
we
found
that
some
of
these
patients
had
a
tuberculous
cause
which
considerably
altered
their
management
as
well
as
their
prognosis
.
We
herein
present
our
experience
of
these
patients
whom
we
had
operated
with
a
preoperative
diagnosis
of
biliary
tract
malignancy
and
discuss
,
retrospectively
,
how
they
might
have
been
detected
before
operation
to
have
tuberculosis
.
Between
August
1996
and
June
2010
,
we
operated
on
209
patients
with
a
preoperative
diagnosis
of
carcinoma
of
the
gallbladder
and
common
bile
duct
.
Seven
out
of
these
209
patients
had
biliary
tuberculosis
.
We
retrospectively
analyzed
the
clinical
features
of
these
patients
from
our
prospectively
maintained
database
.
There
were
four
males
and
three
females
who
had
a
mean
age
of
54
(
32
-
65
)
years
.
The
bile
duct
was
involved
in
four
and
gallbladder
in
three
patients
.
In
contrast
to
those
with
malignancy
,
patients
with
tuberculosis
had
a
longer
history
(
122
vs
44
Â
days
)
,
an
abdominal
mass
was
present
less
frequently
(
28
%
vs
57
%
)
,
the
serum
bilirubin
was
lower
(
1
.
6
vs
6
Â
mg
/
dl
)
,
and
they
also
had
evidence
of
tuberculosis
elsewhere
in
the
body
(
28
.
5
%
)
.
There
was
no
operative
mortality
in
biliary
tract
tuberculosis
in
contrast
to
7
.
5
%
in
biliary
tract
malignancy
.
Though
tuberculosis
of
the
biliary
tract
is
rare
,
it
needs
to
be
considered
in
the
differential
diagnosis
of
patients
with
biliary
obstruction
especially
in
countries
where
the
disease
is
endemic
.
