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Case Reports: Reminder of important clinical lesson
Hilar tuberculosis versus Klatskin tumour: a diagnostic challenge
  1. Jyotirmoy Biswas1,
  2. Roger B Rathna2,
  3. Arkadeep Dhali3 and
  4. Sukanta Ray3
  1. 1General Medicine, College of Medicine and Sagore Dutta Hospital, Kolkata, West Bengal, India
  2. 2Critical Care Medicine, St John's Medical College Hospital, Bangalore, Karnataka, India
  3. 3GI Surgery, IPGME and R, Kolkata, West Bengal, India
  1. Correspondence to Dr Arkadeep Dhali; arkadipdhali{at}gmail.com; Professor Sukanta Ray; drsukantaray{at}yahoo.co.in

Abstract

Hepatobiliary tuberculosis is a rare condition causing obstructive jaundice either by enlarged lymph nodes around the bile ducts or involvement of biliary epithelium by the tuberculous process. Since a tissue diagnosis is not mandatory to proceed with the resection or initiation of a liver transplant protocol, benign lesions are occasionally misdiagnosed as hilar cholangiocarcinoma. Here, we present a case of hepatobiliary tuberculosis which presented as obstructive jaundice due to hilar obstruction. The mass causing the obstruction was then later found to be a pseudotumour, typical of tuberculosis. This diagnosis meant that extensive surgical resection as a protocol for cholangiocarcinoma was avoided. The patient recovered completely after a course of antitubercular therapy.

  • General surgery
  • Tropical medicine (infectious disease)

https://doi.org/10.1136/bcr-2022-252511

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    Footnotes

    • JB and RBR are joint first authors.

    • Contributors JB: writing the draft of manuscript. RR: writing the draft of manuscript. AD: data collection and critical assesment of the case. SR: review and modification of the final manuscript.

    • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

    • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

    • Competing interests None declared.

    • Provenance and peer review Not commissioned; externally peer reviewed.