263 Tuberculosis of the Bile Duct: A Rare Cause of Obstructive Jaundice

Tuberculosis (TB) is a very rare cause of biliary stricture that is difficult to diagnose and usually requires surgical intervention in order to rule out underlying malignant etiology. A 28-years old woman with obstructive jaundice, who was originally thought to have cholangio-carcinoma. Diagnosis of tuberculosis was made on PCR testing of bile. Patient was started on antitubercular treatment, and she responded well. This case presented a rare case of common bile duct stricture due to biliary tuberculosis. This is an important condition to diagnose because early recognition with prompt treatment results in complete resolution. Even though biliary tuberculosis is a rare cause of obstructive jaundice, in endemic areas, it should be considered as a differential diagnosis and investigated, as it can be potentially curable.

Bidirectional energy cascade in surface capillary waves

Based on an experiment and simulations, we report that an energy cascade in surface capillary waves can be bidirectional, that is, can simultaneously flow towards large and small wavelength scales from the pumping scales. The bidirectional energy cascade provides an effective global coupling mechanism between the scales. We show that formation of the bidirectional cascade leads to creation of large-scale, large-amplitude waves on the fluid surface.