Tuberculosis of biliary tract: A rare cause of common bile duct stricture

Abstract

Benign biliary strictures fall into two aetiological groups: traumatic

Uncommon presentation of a common disease

“…Ultrasound and CT cannot easily differentiate between malignant and tuberculosis-related masses and a recent trend is to use endoscopic-ultrasound and fine-needle aspiration cytology analysis for diagnosis2 which improves the diagnostic yield. Tuberculous strictures of CBD also seen in this case has been reported previously 3. Regions where tuberculosis is common, any mass in the head of the pancreas should raise the possibility of tuberculosis and tissue diagnosis should be obtained before proceeding to invasive procedures as pancreatic tuberculosis and tuberculous CBD strictures respond well to antituberculosis treatment.…”

Secondary sclerosing cholangitis in localized hepatobiliary tuberculosis simulating cholangiocarcinoma: a rare case report

“…The diffuse form occurs if the bacilli reach heaptic parenchyma via hepatic artery from lungs or through portal vein in case of gastrointestinal involvement. In localised form, bacilli may reach liver via lymphatics or through rupture of a tuberculous lymph node at porta [ 3 , 5 ]. Biliary involvement can be secondary to AFB excretion into bile producing strictures or due to compression by enlarged nodes or hepatic granulomas, leading to obstructive jaundice [ 1 ].…”

“…It is often difficult to differentiate benign and malignant causes of biliary stricture because clinical, laboratory findings including LFTs and cholangiography are non-specific [ 5 ]. Treatment HBTB is mainly medical and surgery may be required if there is biliary involvement.…”

“…Grossly, liver can show nodules (tuberculoma/tubercular abscess) which may mimick primary or metastatic malignancy [ 1 ]. Biliary involvement can lead to diffuse thickening or strictures resembling primary sclerosing cholangitis or cholangiocarcinoma [ 5 , 6 ]. In our case too, possibility of malignancy could not be ruled out on gross examination.…”

“…SSC aetiologies are various, including infection. In HBTB, SSC-like changes have been described on cholangiography [ 5 , 6 ]. However in our case, similar changes were seen on histology, which have not been previously described.…”