Primary Liver Abscess with Anterior Abdominal Wall Extension Caused by Mycobacterium tuberculosis Complex
Published: November 1, 2016 | DOI: https://doi.org/10.7860/JCDR/2016/21845.8795
Jayashri Sanjay Pandya, Rahul Vilas Kandekar, Ajeet Ramamani Tiwari, Rahul Kadam, Devbrata Radhikamohan Adhikari
1. Professor, Head of Unit and Trauma Incharge, Department of General Surgery, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable
Hospital, Mumbai, Maharashtra, India.
2. Resident, Department of General Surgery, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, Maharashtra, India.
3. Resident, Department of General Surgery, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, Maharashtra, India.
4. Resident, Department of General Surgery, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital, Mumbai, Maharashtra, India.
5. Assistant Professor, Department of General Surgery, Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital,
Mumbai, Maharashtra, India.
Correspondence
Dr. Ajeet Ramamani Tiwari,
Resident, Department of General Surgery,
Topiwala National Medical College and Bai Yamunabai Laxman Nair Charitable Hospital,
Mumbai, Central-400008, Maharashtra, India.
E-mail: drajeetramantiwari@gmail.com
Tubercular liver abscess is generally secondary to some other primary foci in the body, most notably pulmonary and gastrointestinal system. To find primary tubercular liver abscess is rare, with prevalence of 0.34% in patients with hepatic tuberculosis. Abscess tracking into abdominal wall from spinal and para spinal tuberculosis is known, however primary liver tuberculosis rupturing into anterior abdominal wall has been reported only twice in literature. We report a case of 43-year-old female with direct invasion of the anterior abdominal wall from an isolated tubercular parenchymal liver abscess, caused by Mycobacterium tuberculosis complex, diagnosed primarily on smear for Acid Fast Bacilli (AFB), imaging and isolated by culture and BACTEC MGIT 960 KIT. We discuss here the diagnostic dilemma, management and outcome of primary tubercular liver parenchymal abscess with direct invasion into anterior abdominal wall.
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