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Common bile duct perforation due to tuberculosis: a case report
Razman Jarmin1, Rizal Imran Alwi, Shaharin Shaharuddin
1Department of Surgery, Faculty of Medicine, Universiti Kebangsaan Malaysia, Kuala Lumpur, Malaysia. razman@mail.hukm.ukm.my
Asian Journal of Surgery
|November 27, 2004
Summary
A rare case of spontaneous common bile duct perforation occurred in an HIV-positive man. The perforation was caused by Mycobacterium tuberculosis, a highly unusual presentation of bile duct tuberculosis.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Hepatology
Background:
- Tuberculosis (TB) typically affects the lungs but can manifest in various organs.
- Biliary tract tuberculosis is rare, usually causing obstructive jaundice via strictures.
- Spontaneous common bile duct perforation is a critical surgical emergency.
Observation:
- A young HIV-positive male presented with symptoms of biliary peritonitis.
- Imaging and subsequent investigation identified a spontaneous perforation of the common bile duct.
- The causative agent for the perforation was confirmed as Mycobacterium tuberculosis.
Findings:
- This case represents an extremely rare instance of bile duct perforation due to tuberculosis.
- The patient's presentation differed from typical biliary tuberculosis, which usually involves strictures and jaundice.
- The diagnosis required thorough investigation to identify the unusual etiology.
Implications:
- Highlights the diverse and rare presentations of Mycobacterium tuberculosis infections.
- Emphasizes the importance of considering unusual etiologies in immunocompromised patients with abdominal emergencies.
- Discusses the management challenges and strategies for this rare condition, contributing to clinical knowledge.