Case Report on Secondary Sclerosing Cholangitis in Localized Hepatobiliary Tuberculosis Simulating Cholangiocarcinoma

Abstract

Background: Especially in underdeveloped countries, tuberculosis (TB) is a major source of morbidity and mortality and a global health issue. Even though pneumonic inclusion extra-pneumonic TB, which is generally pervasive, is a critical clinical issue. With involvement of abdominal TB is one of the most prevalent forms of the illness and can affect the gastrointestinal, splenic, pancreatic, hepatobiliary, peritoneal, omental, mesenteric, and/or abdominal lymph nodes. The signs and symptoms can be vague and imitate other diseases, such as cancers. Chronic cholestasis disease known as sclerosing cholangitis is characterized by inflammation, bile duct obliterative fibrosis, stricture development, and biliary damage that worsens over time and eventually leads to cirrhosis. There are two types: primary/idiopathic (which is the more typical variety) and acquired/secondary. Some of the latter's causes include immune disorders, ischemia, infections, parasites, infiltrative processes, and metastases. In this case study, we describe a rare occurrence of localized hepatobiliary tuberculosis (HBTB) that led to secondary sclerosing cholangitis (SSC). Case Presentation: A 50-year-old man with acutely developing jaundice, considerable weight loss and increased liver enzymes presented with cholangiocarcinoma being suspected clinical-radiologically. A left hepatectomy revealed dilated bile ducts filled with caseous necrotic debris. Based on histology, the hepatobiliary TB had localized secondary sclerosing cholangitis-like features. Conclusion: Localized hepatobiliary tuberculosis can be difficult to diagnose, so it should be taken into account, especially in endemic areas.