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;
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.
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.
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