Shabbir Hussain Rana, Syed Inamullah Shah, Aurangzeb Khan.
Gall bladder Tuberculosis - A case report.
J Surg Pak Jan ;9(1):52-3.

An 80-year old man presented with mild right upper quadrant abdominal pain of six months duration. The pain exacerbated off and on. Clinical examination of the patient revealed a mildly tender right hypochondrium. No mass or enlarged viscus was palpable. Ultrasonography of abdomen revealed a contracted gallbladder containing multiple calculi. Chest X-ray was suggestive of chronic obstructive airway disease (COAD). His hemoglobin was 12.6 gm/dl and total leukocyte count was 5.6x10e9/L. Neutrophils were 65% while lymphocytes were 30%. Blood glucose levels and liver function tests were within normal limits. Hepatitis B surface antigen and anti-HCV antibodies were negative. Peroperatively, gallbladder was seen to be contracted and had thickened walls. Its serosal surface was granular. The greater omentum and mesentery were studded with nodules. No spread was seen into the gallbladder fossa or into the liver. Lymph node of Lund and those in the mesentery were enlarged. Gallbladder contained multiple small calculi. The resected gallbladder and a biopsy of greater omentum were sent for histopathology, which revealed gallbladder tuberculosis with caseating granulomas, as well as tuberculous omentitis. Patient is on anti-tuberculosis therapy and is improving steadily.

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