Hepatic tuberculosis: a report of one case and literature data analysis of 158 cases_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

ZHOUMiao ,  DUIDanhua , AOYu , ZHAOJianfeng , DUJie

Department of General Surgery, Affiliated Hospital of Zunyi Medical College, Zunyi, Guizhou 563000, P. R. China;

Corresponding author：

DUIDanhua, Email: 2361169015@qq.com

Keywords：

hepatic tuberculosis; clinical manifestations; diagnosis; treatment

DOI：

10.7507/1007-9424.201605068

Video：

Export PDF Favorites Scan Get Citation

Abstract Full text Figures/Tables Video References Cited by

Objective To investigate the clinical and imaging manifestations, laboratory examination, diagnosis, treatment and prognosis of hepatic tuberculosis, and improve the understanding of hepatic tuberculosis. Methods One case of hepatic tuberculosis that treated by author was reported, at the same time, the domestic literatures were retrieved from 2000 to 2015, 158 cases of hepatic tuberculosis were collected, and the clinical manifestations, imaging examination, diagnosis and prognosis of 159 cases were analyzed. Results ①In 159 cases, male patients were in the majority, male and female ratio was about 2:1. Symptom with fever (68.55%), liver discomfort (43.40%), loss of appetite and fatigue (40.88%) were the main performance. ②Results of laboratory examination: erythrocyte sedimentation rate increased (71.76%), abnormal liver function (58.49%), and lower hemoglobin (52.83%). ③The comparation of imaging diagnosis: the positive rates of CT and B-ultrasound were no significant difference (P＞0.05), there existed significantly difference between MRI, B-ultrasound and CT, MRI had a higher positive rate (P＜0.05). ④The preoperative diagnosis rate of hepatic tuberculosis about 13.84%, was low. The misdiagnosis rate was high, during which liver cancer were the most common misdiagnosed. Diagnosis mainly depends on pathological examination. ⑤Medical treatment was the main treatment, and it’s effect was good. Conclusions Hepatic tuberculosis lacked specific clinical manifestations, and the imaging features of various, the diagnostic rate of hepatic tuberculosis was low, and the misdiagnosis rate was high. In order to definite it, histopathological examination is necessary. The first choice of treatment is drug therapy, which is good.

Citation： ZHOUMiao, DUIDanhua, AOYu, ZHAOJianfeng, DUJie. Hepatic tuberculosis: a report of one case and literature data analysis of 158 cases. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2017, 24(1): 80-84. doi: 10.7507/1007-9424.201605068 Copy

1.	Chaudhary P. Hepatobiliary tuberculosis. Ann Gastroenterol, 2014, 27(3): 207-211.
2.	Hussain W, Mutimer D, Harrison R,et al. Fulminant hepatic failure caused by tuberculosis. Gut, 1995, 36(5): 792-794.
3.	王黎霞, 成诗明, 陈明亭, 等. 2010年全国第五次结核病流行病学抽样调查报告. 中国防痨杂志, 2012, 34(8): 485-508.
4.	Park JI. Primary hepatic tuberculosis mimicking intrahepatic cholangiocarcinoma: report of two cases. Ann Surg Treat Res, 2015, 89(2): 98-101.
5.	Ratziu V, Lalazar A, Wong L,et al. Zf9, a Kruppel-like transcription factor up-regulatedin vivo during early hepatic fibrosis. Proc Natl Acad Sci U S A, 1998, 95(16): 9500-9505.
6.	Bandyopadhyay S, Maity PK. Hepatobiliary tuberculosis. Assoc Physicians India, 2013, 61(6): 404-407.
7.	Rodriguez-Framil M, Antela A, Prieto A,et al. Tuberculous hepatic abscess appearing after liver transplantation in a patient with human immunodeficiency virus and hepatitis B and C virus co-infection. Transpl Infect Dis, 2011, 13(5): 515-519.
8.	Hickey N, McNulty JG, Osborne H,et al. Acute hepatobiliary tuberculosis: a report of two cases and a review of the literature. Eur Radiol, 1999, 9(5): 886-889.
9.	苏伟华. 肝结核的病理特征及相关问题分析. 中外医疗, 2012, 31(5): 52-53.
10.	Cao BS, Li XL, Li N,et al. The nodular form of hepatic tuberculosis: contrast-enhanced ultrasonographic findings with pathologic correlation. Ultrasound Med, 2010, 29(6): 881-888.
11.	周震, 周新华, 吕岩, 等. CT诊断肝结核. 中国介入影像与治疗学, 2010, 7(4): 443-446.
12.	余日胜, 孙继红, 李蓉芬. 肝结核的CT与MRI表现. 中华放射学杂志, 2001, 35(5): 367-369.
13.	严福华, 李若坤. 肝脏结核的CT及MRI诊断. 诊断学理论与实践, 2015, 14(5): 421-424.
14.	Alcantara-Payawal DE, Matsumura M, Shiratori Y,et al. Direct detection of Mycobacterium tuberculosis using polymerase chain reaction assay among patients with hepatic granuloma. Hepatol, 1997, 27(4): 620-627.
15.	Hickey AJ, Gounder L, Moosa MY,et al. A systematic review of hepatic tuberculosis with considerations in human immunodeficiency virus co-infection. BMC Infect Dis, 2015, 15: 209.
16.	Hillemann D, Rusch-Gerdes S, Boehme C,et al. Rapid molecular detection of extrapulmonary tuberculosis by the automated GeneXpert MTB/RIF system. Clin Microbiol, 2011, 49(4): 1202-1205.
17.	Cudahy P, Shenoi SV. Diagnostics for pulmonary tuberculosis. Postgrad Med J, 2016, 92(1086): 187-193.
18.	Yu HY, Sheng JF. Liver tuberculosis presenting as an uncommon cause of pyrexia of unknown origin: positron emission tomography/computed tomography identifies the correct site for biopsy. Med Princ Pract, 2014, 23(6): 577-579.
19.	Tsuda S, Oleynikov D, Gould J,et al. SAGES TAVAC safety and effectiveness analysis: da Vinci^® Surgical System (Intuitive Surgical, Sunnyvale, CA). Surg Endosc, 2015, 29(10): 2873-2884.
20.	Chen R, Wang J, Zhang Y,et al. Key factors of susceptibility to anti-tuberculosis drug-induced hepatotoxicity. Arch Toxicol, 2015, 89(6): 883-897.
21.	Sonika U, Kar P. Tuberculosis and liver disease: management issues. Trop Gastroenterol, 2012, 33(2): 102-106.
22.	王炳煌. 肝结核的诊断与治疗. 医师进修杂志, 2002, 25(3): 7-8.
23.	Storla DG, Yimer S, Bjune GA. A systematic review of delay in the diagnosis and treatment of tuberculosis. BMC Public Health, 2008, 8: 15.
24.	Huang WT, Wang CC, Chen WJ,et al. The nodular form of hepatic tuberculosis: a review with five additional new cases. Clin Pathol, 2003, 56(11): 835-839.

1. Chaudhary P. Hepatobiliary tuberculosis. Ann Gastroenterol, 2014, 27(3): 207-211.
2. Hussain W, Mutimer D, Harrison R,et al. Fulminant hepatic failure caused by tuberculosis. Gut, 1995, 36(5): 792-794.
3. 王黎霞, 成诗明, 陈明亭, 等. 2010年全国第五次结核病流行病学抽样调查报告. 中国防痨杂志, 2012, 34(8): 485-508.
4. Park JI. Primary hepatic tuberculosis mimicking intrahepatic cholangiocarcinoma: report of two cases. Ann Surg Treat Res, 2015, 89(2): 98-101.
5. Ratziu V, Lalazar A, Wong L,et al. Zf9, a Kruppel-like transcription factor up-regulatedin vivo during early hepatic fibrosis. Proc Natl Acad Sci U S A, 1998, 95(16): 9500-9505.
6. Bandyopadhyay S, Maity PK. Hepatobiliary tuberculosis. Assoc Physicians India, 2013, 61(6): 404-407.
7. Rodriguez-Framil M, Antela A, Prieto A,et al. Tuberculous hepatic abscess appearing after liver transplantation in a patient with human immunodeficiency virus and hepatitis B and C virus co-infection. Transpl Infect Dis, 2011, 13(5): 515-519.
8. Hickey N, McNulty JG, Osborne H,et al. Acute hepatobiliary tuberculosis: a report of two cases and a review of the literature. Eur Radiol, 1999, 9(5): 886-889.
9. 苏伟华. 肝结核的病理特征及相关问题分析. 中外医疗, 2012, 31(5): 52-53.
10. Cao BS, Li XL, Li N,et al. The nodular form of hepatic tuberculosis: contrast-enhanced ultrasonographic findings with pathologic correlation. Ultrasound Med, 2010, 29(6): 881-888.
11. 周震, 周新华, 吕岩, 等. CT诊断肝结核. 中国介入影像与治疗学, 2010, 7(4): 443-446.
12. 余日胜, 孙继红, 李蓉芬. 肝结核的CT与MRI表现. 中华放射学杂志, 2001, 35(5): 367-369.
13. 严福华, 李若坤. 肝脏结核的CT及MRI诊断. 诊断学理论与实践, 2015, 14(5): 421-424.
14. Alcantara-Payawal DE, Matsumura M, Shiratori Y,et al. Direct detection of Mycobacterium tuberculosis using polymerase chain reaction assay among patients with hepatic granuloma. Hepatol, 1997, 27(4): 620-627.
15. Hickey AJ, Gounder L, Moosa MY,et al. A systematic review of hepatic tuberculosis with considerations in human immunodeficiency virus co-infection. BMC Infect Dis, 2015, 15: 209.
16. Hillemann D, Rusch-Gerdes S, Boehme C,et al. Rapid molecular detection of extrapulmonary tuberculosis by the automated GeneXpert MTB/RIF system. Clin Microbiol, 2011, 49(4): 1202-1205.
17. Cudahy P, Shenoi SV. Diagnostics for pulmonary tuberculosis. Postgrad Med J, 2016, 92(1086): 187-193.
18. Yu HY, Sheng JF. Liver tuberculosis presenting as an uncommon cause of pyrexia of unknown origin: positron emission tomography/computed tomography identifies the correct site for biopsy. Med Princ Pract, 2014, 23(6): 577-579.
19. Tsuda S, Oleynikov D, Gould J,et al. SAGES TAVAC safety and effectiveness analysis: da Vinci^® Surgical System (Intuitive Surgical, Sunnyvale, CA). Surg Endosc, 2015, 29(10): 2873-2884.
20. Chen R, Wang J, Zhang Y,et al. Key factors of susceptibility to anti-tuberculosis drug-induced hepatotoxicity. Arch Toxicol, 2015, 89(6): 883-897.
21. Sonika U, Kar P. Tuberculosis and liver disease: management issues. Trop Gastroenterol, 2012, 33(2): 102-106.
22. 王炳煌. 肝结核的诊断与治疗. 医师进修杂志, 2002, 25(3): 7-8.
23. Storla DG, Yimer S, Bjune GA. A systematic review of delay in the diagnosis and treatment of tuberculosis. BMC Public Health, 2008, 8: 15.
24. Huang WT, Wang CC, Chen WJ,et al. The nodular form of hepatic tuberculosis: a review with five additional new cases. Clin Pathol, 2003, 56(11): 835-839.

CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Hepatic tuberculosis: a report of one case and literature data analysis of 158 cases

Abstract Full text Figures/Tables Video References Cited by

Previous Article

Next Article

Format

Content