Abstract
TUBERCULOSIS OF THE GALLBLADDER: A DIAGNOSTIC DILLEMA
Maria Joscel D. Torres, MD
Significance: Because of its rarity and similar manifestation with calculous, acalculous cholecystitis or cystic duct obstruction, most cases of Gallbladder Tuberculosis are misdiagnosed. A preoperative diagnosis of this disease is difficult, thus awareness among clinicians needs to be improved.
Clinical Presentation: A 24 year old male who presented with similar features of acute cholecystitis with choledocholithiasis. He had no other comorbidities and no history of tuberculosis.
Management: Patient underwent ERCP and laparoscopic cholecystectomy with worsening of symptoms. MRCP showed a non-obstructed dilatation of the intrahepatic and extrahepatic ducts, with beaded appearance of the left intrahepatic ducts and smooth tapering at the confluence suggestive of an inflammatory process. ERCP with stenting was repeated. Tuberculosis of the Gallbladder was considered based on the histopathologic findings of caseating granuloma with langhans giant cells. Patient was started on Anti tuberculosis medications for 6 months.
Recommendation: Since Tuberculosis of the Gallbladder can be managed medically, It should be considered as part of the differential diagnosis in patients presenting with calculous, acalculous cholecystitis or cystic duct obstruction, especially in endemic areas like the Philippines.
Keywords: Gallbladder; Tuberculosis; Cholecystitis
Important Dates to Remember
| JRRE Activities 2023-2024 |
Proposed Dates |
|---|---|
| Resumption of face-to-face Evidence-Based Medicine Workshop Venue to be announced once finalized. |
July 21, 2023 (Friday), 1-5pm |
| Monthly Critical Appraisal of Topics Conferences to be gaciliated by Research Coordinators per Institution | Monthly Critical Appraisal of Topics Conferences per Institution |
| CAT Plenary/Liver Con Dates: September 23, 2023 December 16, 2023 March 2024 (During the JAC) Resumption of face-to-face Quarterly Critical Appraisal of Topics facilitated by the JRRE |
2 Clinical scenarios and articles are to be sent to institutions each on August 2023, November 2023, and February 2024; |
| Hybrid Research Workshop 4 week asynchronous via Moodle, followed by a 1 day on-site Onsite Workshop Research Protocol Presentation for Level I GI Fellows-In-Training - Research Protocol Presentation: August 12, 2023 - Research Forums of the Tripartite Societies |
Week 1: July 15-21, 2023 Week 2: July 22-28, 2023 Week 3: July 29-August 4, 2023 Week 4: August 5-11, 2023 |
| Research Manuscript Workshop for level II GI Fellows-In-Training | January 6, 2024 |