Portal Hypertension Secondary to Isolated Liver Tuberculosis

Abstract

Abstract. In this report, we present a case of isolated liver tuberculosis (TB) as a cause of non-cirrhotic portal hypertension leading to bleeding esophageal varices. Although TB has been known to cause portal hypertension in a variety of ways, this case was notable for the presence of periportal inflammation and granulomas, also seen in hepatic schistosomiasis. Herein, we discuss isolated liver TB and the differential diagnosis of non-cirrhotic portal hypertension. In endemic areas, TB should be considered in the differential diagnosis of non-cirrhotic portal hypertension.

Hepatobiliary Tuberculosis: Imaging Findings

“…Nonspecific hepatomegaly is the most commonly detected finding, which is generally not helpful for the correct diagnosis. Fortunately, miliary TB is the rarest form of primary hepatic TB and is reported to have an overall frequency of 0.3% [25][26][27]. On ultrasound, the liver in some cases may appear as diffusely echogenic and mildly heterogeneous [15].…”

Hepatosplenic tuberculosis simulating secondary malignant lesions with cholangitis

“…It can also go through the portal circulation, leading to macronodular, pseudotumoral or abscesses forms, often associated with intestinal localization [ 4 ]. It can be complicated with portal hypertension [ 5 ]. In our patient, the presence of hepatic and splenic macronodular lesions would be in favor of portal vein dissemination.…”

Isolated hepatosplenic tuberculosis: a rare presentation

“…The diagnosis of hepatic and splenic TB is challenging, as the clinical presentations are non-specific and range from being asymptomatic to manifesting fever, weakness, weight loss, abdominal pain, hepatosplenomegaly and, rarely, portal hypertension 1 7 8. To add to this dilemma, most patients do not have a history of prior exposure to TB.…”