Korean J Gastrointest Endosc.  2007 Oct;35(4):287-291.

A Case of Surgical Treatment of Tuberculous Cholangitis and Lymphadenitis with Obstructive Jaundice due to Progressive Stricture of Bile Duct

• Kim KH
• Ku YS
• Kim KK
• Kim HO
• Kim GH
• Ko KI
• Chung NS
• Yu SK
• Park DK
• Kwon KA
• Kim YS
• Kim YK
• Kim JH

Abstract

Obstructive jaundice is most commonly attributed to a malignancy or stones affecting the common bile duct. Biliary tuberculosis and lymphadenitis around the periportal area have also been implicated but cases are quite rare. A 24 year old man presented with jaundice and abdominal pain for 3 days. Abdominal CT and ERCP revealed a stricture of the extrahepatic bile duct with multiple enlarged lymph nodes showing necrotic foci located at the periportal area. The colonoscopic biopsy showed evidence of M. tuberculosis. The patient was treated with ERBD insertion and oral anti-tuberculosis therapy. However, the abdominal pain recurred and there was progressive stenosis of the common bile duct. A bile duct resection with choledochojejunostomy was subsequently performed. Frozen sections revealed granulomatous inflammation with caseation necrosis, which was consistent with tuberculosis. We report a case of tuberculous cholangitis and lymphadenitis with obstructive jaundice that was managed surgically due to the progressive stricture of the bile duct.

Keyword

Biliary tuberculosis; Tuberculous lymphadenitis; Obstructive jaundice

MeSH Terms

Abdominal Pain
Bile Ducts*
Bile Ducts, Extrahepatic
Bile*
Biopsy
Cholangiopancreatography, Endoscopic Retrograde
Cholangitis*
Choledochostomy
Common Bile Duct
Constriction, Pathologic*
Frozen Sections
Humans
Inflammation
Jaundice
Jaundice, Obstructive*
Lymph Nodes
Lymphadenitis*
Necrosis
Tomography, X-Ray Computed
Tuberculosis
Tuberculosis, Lymph Node
Young Adult