A Case of Surgical Treatment of Tuberculous Cholangitis and Lymphadenitis with Obstructive Jaundice due to Progressive Stricture of Bile Duct
Kil Hyun Kim, M.D., Yang Suh Ku, M.D., Koen Kuk Kim, M.D.*, Hyun Ok Kim, M.D., Geum Ha Kim, M.D., Kwang Il Ko, M.D., Nak So Chung, M.D., Sang Kyun Yu, M.D., Dong Kyun Park, M.D., Kwang An Kwon, M.D., Yeon Suk Kim, M.D., Yu Kyung Kim, M.D. and Ju Hyun Kim,
Departments of Internal Medicine, *Surgery, Gachon University Gil Medical Center, Incheon, Korea
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. (Korean J Gastrointest Endosc 2007;35:287-291)
PDF Links
Full text via DOI 
Download Citation 
