ABSTRACT
It is a very rare affection even in our country which is a tuberculous endemic country. The physipathological mechanism is still controversial, lithiasis plays a role in supporting the tuberculous localization in the gallbladder which decreases the vesicular resistance against bacillus of Koch. It is about a case of tuberculosis of the gallbladder of an operated patient for chronic lithiasis cholecystitis which appears to have a direct relation with the vesicular lithiasis. Its diagnosis depends on the histological examination of the piece of cholecystoctomy. This pathology represents 1% of the digestive turberculosis localization. Its clinical signs are not specific. The biological assessment shown the presence of blooc lymphocytosis which is in favor of a possible tuberculosis, but rarely found. The only certitude diagnosis is the anatomopathological examination of the excised piece of cholecystoctoy by finding the evidence of the epitheloidal and granulomatous inflammation and cellular overgrowth with caseous necrosis. The physiopathological mechanism is still discussed. The presence of calculus resulting in disappearance of biliary acids and provokes a non specific inflammatory reaction to the vesicular mucosa which decreases the vesicular resistance against bacillus of Koch. This possibility shows an increase in frequency in the developed countries due to the emerging of AIDS. The impact of the lithiasis on the appearance of this specific inflammation is possible but remains discussed. Its treatment is medico-surgical