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Tuberculous biliary stricture

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Abstract

Tuberculosis (TB) of the hepatobiliary system is not uncommon, but as a cause of biliary strictures, it is very rare. It poses difficulty in diagnosis and often requires surgical intervention to exclude underlying malignancy. To our knowledge, there are fewer than 20 reported cases in the English literature. We report a 35-year-old Filipino woman who presented with a 3-day history of obstructive jaundice, associated with significant weight loss and anorexia. Computed tomography (CT) revealed dilated intrahepatic biliary system secondary to distal stricture at the confluence of the left and right bile ducts. Magnetic resonance cholangiopancreatography characterised the lesion as an irregular stricturing at several sites in the common bile duct. Incidentally, the scans also showed indeterminate pulmonary nodules in the right lower lobes. CT thorax confirmed bilateral involvement of the lungs. She required percutaneous transhepatic drainage for biliary decompression. Tests on tissue from the lung lesions, the blood, and the bile all confirmed the presence of TB. She was treated with anti-TB medication. This report emphasizes the importance of considering TB as a possibile cause of biliary stricture, especially in South-East Asia.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of General Surgery, Singapore General Hospital, Outram Road, Singapore, 169608, Singapore

    S. Y. Lee, C. Y. Gary Kang & K. H. Pierce Chow

  2. Department of Surgical Oncology, National Cancer Centre, Singapore, 11 Hospital Drive, Singapore, 169610, Singapore

    S. Y. Lee

  3. Department of Diagnostic Radiology, Singapore General Hospital, Outram Road, Singapore, 169908, Singapore

    S. C. Albert Low

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  1. S. Y. Lee
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  2. C. Y. Gary Kang
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  4. K. H. Pierce Chow
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Correspondence to S. Y. Lee.

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Lee, S.Y., Kang, C.Y.G., Low, S.C.A. et al. Tuberculous biliary stricture. Clin J Gastroenterol 5, 53–58 (2012). https://doi.org/10.1007/s12328-011-0278-x

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  • DOI: https://doi.org/10.1007/s12328-011-0278-x

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