Korean J Gastrointest Endosc > Volume 35(4); 2007 > Article
Korean Journal of Gastrointestinal Endoscopy 2007;35(4): 287-291.
결핵성 담관염과 림프절염에 의한 진행성 담관협착을 수술로 치료한 1예
김길현ㆍ구양서ㆍ김건국*ㆍ김현옥ㆍ김금하ㆍ고광일ㆍ정낙소ㆍ유상균ㆍ박동균ㆍ권광안ㆍ김연석ㆍ김유경ㆍ김주현
가천의과학대학교 길병원 내과학교실, *외과학교실
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)
Key Words: Biliary tuberculosis, Tuberculous lymphadenitis, Obstructive jaundice
주요어: 결핵성 담관염, 결핵성 림프절염, 폐쇄성 황달
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