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Distal Common Bile Duct Tuberculosis with Obstructive Jaundice: A Case Report.

M M Chowdhury¹, A K Ullah, M J Hossain

¹Professor Md Mohsen Chowdhury, Professor & Head of the Yellow Unit II, Department of Hepatobiliary Pancreatic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh;

Mymensingh Medical Journal : MMJ

|March 7, 2017

Summary

Tuberculosis (TB) of the common bile duct (CBD) is rare. This case highlights TB mimicking cholangiocarcinoma, emphasizing the need for thorough diagnosis and appropriate anti-microbial therapy.

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Published on: March 25, 2022

Area of Science:

Gastroenterology
Infectious Diseases
Surgical Oncology

Background:

Tuberculosis (TB) rarely affects the biliary tract, specifically the common bile duct (CBD).
Distinguishing CBD tuberculosis from malignancy like cholangiocarcinoma presents diagnostic challenges.

Observation:

A 40-year-old male presented with obstructive jaundice, initially suspected to be distal CBD cholangiocarcinoma.
Imaging (ultrasonography, MRCP) revealed a mass in the distal CBD, leading to a Whipple procedure.
Histopathology confirmed distal CBD tuberculosis, involving the pancreatic head and lymph nodes.

Findings:

The resected specimen showed classical features of tuberculosis, not malignancy.
The patient received a 12-month course of anti-microbial therapy for TB.

Implications:

This case underscores the importance of considering rare infections like tuberculosis in the differential diagnosis of biliary tract masses.
Accurate diagnosis is crucial for appropriate treatment, avoiding unnecessary radical surgery.
Successful management with anti-microbial therapy highlights the curability of CBD tuberculosis.