Hepatic tuberculosis--a case report.

Though abdominal tuberculosis is fairly common in our country, incidence of tuberculous hepatitis is rare. The authors reported a case who presented to the surgical OPD of the NRS Medical College, Calcutta with complaints of right upper quadrant abdominal pain, flatulent dyspepsia, nausea and occasional vomiting. Ultrasonography (USG) revealed fibrotic gall bladder without any calculus suggesting chronic acalculus cholecystitis. On exploration of the abdomen, the gall bladder was found to be fibrotic and thickened without any calculus. Multiple scarred nodules of different sizes were found in the liver. Cholecystectomy was done and a scarring nodule from the liver was taken for histopathological examination which revealed a tuberculous granuloma. Histopathology of the gall bladder showed cholesterosis. The patient responded to antituberculous drugs.

Recent trends in the management of proximal bile duct cancer.

A case of obstructive jaundice in a 55-year-old male patient is reported. Ultrasonography in the case showed a space occupying lesion proximal to porta. Endoscopic retrograde cholangiopancreatography (ERCP) showed complete occlusion of bile duct near porta. The patient was operated upon and the growth was totally excised. The biliary tract was reconstructed by a Roux-en-Y hepaticojejunostomy. The anastomosis was stented in the right and left hepatic ducts and the distal ends were brought out of the abdomen and fixed to the skin. Postoperative recovery was uneventful and the tubes were clamped after 2 weeks. Regular follow-up clinically and radiologically for 3 months showed no recurrence. The tubes were removed after 3 months. The patient is well for last one and half years without any complaint.