摘要
A 36-year-old Philippine woman presented with dark urine and yellow sclera. Endoscopic retrograde cholangiopancreatography （ERCP） confirmed dilatation of the intrahepatic bile ducts and also showed an irregular stricture of the common hepatic duct at the liver hilum. Histological examination of biopsies from the bile duct revealed epithelioid cell granulomas and caseous necrosis. Tubercle bacilli were then detected on polymerase chain reaction （PCR） testing of the bile, giving the diagnosis of biliary tuberculosis. Although microbiological cure was confirmed, the patient developed cicatricial stenosis of the hepatic duct. She underwent repeated treatments with endoscopic biliary drainage （EBD） tubes and percutaneous transhepatic biliary drainage （PTBD） tubes, and the stenosis was corrected after 6 years. We present a case of tuberculous biliary stricture, a condition that requires careful differentiation from the more common malignancies and needs long-term follow-up due to the risk of posttreatment cicatricial stenosis, although it is rare.
与黑暗的尿和黄巩膜介绍的一个 36 岁的菲律宾的女人。内视镜后退 cholangiopancreatography (ERCP ) 证实了肝内胆汁管的膨胀并且也在肝核显示出普通的肝的管的不规则的苛评。从胆汁管的活体检视的组织学的检查揭示了上皮状的房间风湿性肉芽肿和干酪样坏死。小块茎杆菌然后在胆汁测试的聚合酶链反应(PCR ) 上被检测，给胆汁的肺结核的诊断。尽管微生物痊愈被证实，病人开发了肝的管的 cicatricial。她与内视镜的胆汁的排水(EBD ) 经历了重复治疗试管和经皮的 transhepatic 胆汁的排水(PTBD ) 试管，和狭窄在 6 年以后被改正。我们在场有结节的胆汁的苛评的一个盒子，从更普通的恶意要求小心的区别并且由于处理以后的 cicatricial 的风险需要长期的后续的一个条件，尽管它是稀罕的。
作者简介
Correspondence to： Tomohisa Iwai, MD, Department of Gastroenterology, Kitasato University East Hospital, Sagamihara, Japan. t-iwai@poppy.ocn.nc.jp;Telephone： ＋81-42-7489111;Fax： ＋81-42-7498690
