Introduction : Background: The term hepatobiliary tuberculosis refers to the localized form of hepatic tuberculosis as a distinct clinical entity,with signs and symptoms related to the hepatobiliary tract.Here we present a case series of 4 cases focussing on the presentation , the challenges faced in the diagnosis and the management .

Methods : Case 1: 45 year old lady presented to us with complaints of pain Right hypochondrium and on evaluation was found to have a gall bladder mass suspicious of carcinoma gall bladder . She underwent radical cholecystectomy and Post operative biopsy features suggestive of tuberculosis. Case 2: 21 year old lady presented to us with obstructive jaundice and on evaluation was found to have a type 3 B hilar cholangiocarcinoma for which she underwent Right hepatectomy. Her post operative biopsy Showed T2N0 well differentiated adenocarcinoma with coexisting tuberculous biliary stricture.

Results : Case 3 : 50 year old gentleman, case of ethanol related DCLD, underwent deceased donor liver transplant. Intraoperatively he had chylous ascites which was drained but he continued to drain chylous fluid postoperatively through the drain tubes . His explant liver biopsy showed features of cirrhosis with plenty of AFB bacilli. Case 4 : 19 year old male,Presented to us with suspected malignant pancreatic head mass with bilobar liver metastasis .Biopsy taken from the liver lesion showed caseating granuloma suggestive of tuberculosis .

Conclusions : Conclusion: Localised Hepatobiliary tuberculosis is a rare entity and should be considered in the differential diagnosis in equivocal cases in endemic areas.