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Tuberculosis, more commonly referred to as TB, is an infectious disease stemming from Mycobacterium tuberculosis. While it primarily impacts the lungs, TB can also affect other body areas. Given its severity and global impact, timely and accurate diagnosis is crucial for controlling its spread and improving patient outcomes.
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Gastrointestinal: Direct Visualization of Biliary Tuberculosis.

Aniwat Saleepol1, Thitinan Chulroek2, Thanrada Vimonsuntirungsri1

  • 1Gastrointestinal Endoscopy Excellence Center, Division of Gastroenterology, Department of Medicine, Faculty of Medicine Chulalongkorn University and King Chulalongkorn Memorial Hospital, Thai Red Cross Society, Bangkok, Thailand.

Journal of Gastroenterology and Hepatology
|December 12, 2024
PubMed
Summary

Biliary tuberculosis, a rare liver condition, often mimics other diseases. Cholangioscopy (bile duct visualization) with biopsy aids in diagnosing this challenging hepatobiliary tuberculosis.

Keywords:
biliary tuberculosischolangioscopyobstructive jaundicepapillary projection

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Area of Science:

  • Hepatology
  • Gastroenterology
  • Infectious Diseases

Background:

  • Biliary tuberculosis is a rare form of hepatobiliary tuberculosis.
  • It is challenging to differentiate from cholangiopathy or malignancy using standard clinical, imaging, or cholangiogram methods.
  • Cholangioscopy with targeted biopsy offers effective tissue acquisition for diagnosis.

Purpose of the Study:

  • To highlight the diagnostic utility of cholangioscopy in a case of biliary tuberculosis.
  • To demonstrate the effectiveness of direct visualization and biopsy in confirming the diagnosis.

Main Methods:

  • A case of biliary tuberculosis presenting with jaundice, pruritus, and weight loss was investigated.
  • Magnetic Resonance Imaging (MRI) revealed bile duct strictures and stones.
  • Single-operator cholangioscopy identified ductal strictures and stones, followed by targeted biopsy.

Main Results:

  • Laboratory findings indicated obstructive jaundice.
  • Cholangioscopy visualized strictures and a papillary projection at the common hepatic duct.
  • Biopsy confirmed non-necrotizing granulomatous inflammation and detected Mycobacterium tuberculosis complex DNA.

Conclusions:

  • Direct visualization of the bile duct via cholangioscopy significantly aids in the diagnosis of biliary tuberculosis.
  • This technique increases the diagnostic yield for rare hepatobiliary conditions.