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Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
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Tuberculous biliary stricture.

S Y Lee1,2, C Y Gary Kang3, S C Albert Low4

  • 1Department of General Surgery, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore. seryee@yahoo.com.

Clinical Journal of Gastroenterology
|July 17, 2015
PubMed
Summary
This summary is machine-generated.

Tuberculosis (TB) is a rare cause of biliary strictures, often misdiagnosed. This case highlights the importance of considering TB in patients with obstructive jaundice, especially in Southeast Asia.

Keywords:
Biliary strictureBiliary tuberculosisObstructive jaundice

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Area of Science:

  • Hepatology
  • Infectious Diseases
  • Radiology

Background:

  • Hepatobiliary tuberculosis is uncommon.
  • Tuberculosis causing biliary strictures is exceptionally rare, with fewer than 20 cases reported.
  • Diagnosis is challenging and often necessitates surgery to rule out malignancy.

Purpose of the Study:

  • To report a rare case of tuberculosis presenting as biliary stricture.
  • To emphasize the diagnostic challenges and clinical considerations for hepatobiliary TB.
  • To highlight the importance of considering TB in the differential diagnosis of biliary strictures.

Main Methods:

  • Case report of a 35-year-old woman with obstructive jaundice.
  • Diagnostic imaging included Computed Tomography (CT) and Magnetic Resonance Cholangiopancreatography (MRCP).
  • Invasive procedures involved percutaneous transhepatic biliary drainage and tissue/fluid sampling for microbiological analysis.

Main Results:

  • The patient presented with obstructive jaundice, weight loss, and anorexia.
  • Imaging revealed biliary dilatation secondary to common bile duct strictures and pulmonary nodules.
  • Microbiological tests confirmed tuberculosis in lung lesions, blood, and bile.

Conclusions:

  • Tuberculosis should be considered in the differential diagnosis of biliary strictures, particularly in endemic regions.
  • Early diagnosis and treatment with anti-TB medication are crucial.
  • This case underscores the diverse presentations of tuberculosis and its potential to mimic other diseases.