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Isolated common bile duct tuberculosis.

R Valeja1, S Pal, M S Mann

  • 1Department of Surgery and Pathology, Lady Hardinge Medical College, New Delhi.

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
|July 17, 1999
PubMed
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Tuberculosis can affect the common bile duct in isolation. Diagnosis via histology and treatment with surgery and chemotherapy led to full recovery in a patient.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Surgical Pathology

Background:

  • Tuberculosis (TB) is a significant global health issue, typically affecting the lungs.
  • Biliary tract involvement by TB is rare, with common bile duct (CBD) TB being exceptionally uncommon.
  • Isolated CBD TB presents diagnostic challenges due to its rarity and non-specific symptoms.

Observation:

  • A case of a patient presenting with symptoms suggestive of biliary obstruction was investigated.
  • Diagnostic imaging and laboratory tests were performed, but definitive diagnosis remained elusive pre-operatively.
  • Surgical exploration and resection of the affected segment of the common bile duct were undertaken.

Findings:

  • Histological examination of the resected common bile duct specimen confirmed the presence of tuberculous granulomas.

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  • Microbiological analysis of the tissue was positive for Mycobacterium tuberculosis.
  • The patient had no evidence of disseminated or pulmonary tuberculosis.

    • Implications:

    • This case highlights the importance of considering rare presentations of tuberculosis in the differential diagnosis of biliary tract diseases.
    • Histopathological examination of surgical specimens is crucial for diagnosing unusual manifestations of TB.
    • Combined surgical management and antitubercular chemotherapy offer a successful treatment strategy for isolated CBD TB, leading to complete patient recovery.