Hepatobiliary and Splenic Tuberculosis

Tuberculosis is a disease of the developing countries, with rising indications in developed countries, especially in AIDS patients and in immigrant populations. Although pulmonary tuberculosis is the most common form, the incidences of the disseminated and extrapulmonary tuberculosis have recently increased. 15–20% of all tuberculosis cases are extrapulmonary, and of them, 3–11% are abdominal. Abdominal tuberculosis refers to gastrointestinal, splenic, pancreatic, hepatobiliary, and abdominal lymphadenopathy involvement. An isolated splenic or hepatobiliary tuberculosis is quite rare especially in the immune-competent patients. The manifestation can be nonspecific and mimics many conditions, including malignancies. Diagnosis is very difficult because of its presentation in the form of nonspecific symptoms and signs and lack of any defined criteria on imaging studies. For definite diagnosis, histopathological examination, microscopy, culture, serological, and molecular tests are necessary. Surgical procedure can be done for diagnosis or treatment, especially at patients with abscess. The main treatment option is with conventional antituberculous drugs.