Gastrointestinal: Direct Visualization of Biliary Tuberculosis.

IF 3.7 3区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Journal of Gastroenterology and Hepatology Pub Date : 2024-12-11 DOI:10.1111/jgh.16836

Aniwat Saleepol, Thitinan Chulroek, Thanrada Vimonsuntirungsri, Thanawat Luangsukrerk

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Abstract

Background: Biliary tuberculosis is a rare type of hepatobiliary tuberculosis. Clinical presentation, imaging, or cholangiogram are difficult to distinguish from other common causes of cholangiopathy or malignancy. Direct visualization of bile duct via cholangioscopy and targeted biopsy was introduced as one of effective investigations for tissue acquisition and diagnosis.

Case report: We present a case of biliary tuberculosis presented with pruritus, progressive painless jaundice and significant weight loss. Laboratory findings showed an obstructive jaundice. MRI showed multifocal bile duct stricture and intrahepatic duct stone. Single operator cholangioscopy revealed ductal stricture with papillary projection at common hepatic duct and pigmented stone. Targeted biopsy was performed, which showed non-necrotizing granulomatous inflammation and detection of Mycobacterium tuberculosis complex DNA.

Conclusion: Direct visualization via cholangioscopy can aid and increase diagnostic yield of biliary tuberculosis.

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胃肠道：胆道结核的直接可视化。

背景：胆道结核是一种罕见的肝胆结核。临床表现、影像学或胆管造影很难与胆管病或恶性肿瘤的其他常见病因区分。通过胆管镜和靶向活检直接观察胆管是一种有效的组织获取和诊断方法。病例报告：我们提出一个病例胆道结核提出瘙痒，进行性无痛性黄疸和显著体重下降。实验室检查结果为梗阻性黄疸。MRI显示多灶性胆管狭窄及肝内胆管结石。单刀胆道镜检查发现肝总管狭窄，有乳头状突起及色素结石。进行了靶向活检，显示非坏死性肉芽肿性炎症和检测结核分枝杆菌复合体DNA。结论：胆道镜直接显像有助于提高胆道结核的诊断率。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Gastroenterology and Hepatology 医学-胃肠肝病学

CiteScore

7.90

自引率

2.40%

发文量

326

审稿时长

2.3 months

期刊介绍： Journal of Gastroenterology and Hepatology is produced 12 times per year and publishes peer-reviewed original papers, reviews and editorials concerned with clinical practice and research in the fields of hepatology, gastroenterology and endoscopy. Papers cover the medical, radiological, pathological, biochemical, physiological and historical aspects of the subject areas. All submitted papers are reviewed by at least two referees expert in the field of the submitted paper.