Bile Duct Tuberculosis Revealed by Postoperative Stenosis

Lamara A, Gadda M, Rehamnia A, Medjahdi SA, Kouini R, Boukhane M, Harchouche N, Madoui D and LAMARA MR

Published on: 2023-07-06

Abstract

Biliary tuberculosis is a rare form of extrapulmonary tuberculosis that affects the bile ducts. In addition to the usual symptoms of tuberculosis, jaundice remains common and is indicative of biliary stenosis. Stenoses can be single or multiple, isolated, or complex. Radiologically, it is difficult to exclude cholangiocarcinoma [1].

In this study, we report the case of a patient with a history of cholecystectomy complicated by postoperative biliary stenosis that required revision surgery by the same surgeon. This patient was referred to us following postoperative complications responsible for a deterioration in quality of life due to jaundice and pruritus. Imaging showed irregular stenosis of the biliary pathway associated with a biliodigestive fistula, faced with the failure of attempts at retrograde endoscopic drainage and stinting. The patient was operated. Exploration showed extensive biliary stenosis with inflammatory reaction and fibrosis associated with a fistula between the bile duct and stomach. A biliary repair on a Y-shaped loop at the convergence level was performed after resection of the fibrous stenosis and disconnection of the biologistic fistula. The pathology was in favor of biliary tuberculosis. The patient was put on anti-bacillary chemotherapy.