n South African Journal of Surgery - Biliary fistula in AIDS-related abdominal tuberculosis : letters to the editor




Tuberculosis (TB) is often the first manifestation of AIDS. Extrapulmonary disease can occur in up to 40% of these patients, particularly when immunosuppression is advanced. Abdominal TB can mimic common non-infectious abdominal syndromes. Several cases of digestive fistulas attributed to AIDS-associated TB have been described, most of them being oesophageal fistulas from mediastinal lymph nodes. More distal intestinal fistulas are extremely rare. We report what is probably the first case in which a biliary fistula was the first presentation of abdominal TB and AIDS.


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