Esophageal Tuberculosis: An Analysis of Fourteen Cases

Background and objectives: Esophageal tuberculosis is a rare condition. It may be primary or secondary to tuberculosis elsewhere in the body. The present report describes the clinical features, endoscopic findings, radiologic abnormalities and outcome of anti-tuberculous treatment in a series of 14 verified cases of tuberculosis of the esophagus. Methods: All esophagogastroduodenoscopic examinations performed for persistent dysphagia between January 1996 and August 2008 were screened for the presence of esophageal ulcers or mass lesions; of them with verified diagnosis of esophageal tuberculosis constituted the study group. Results: There were 3 men and 11 women whose age ranged from 25-70 years (mean 38.6 years). The presenting complaints were dysphagia (11 patients), odynophagia (6 patients), fever with weight loss (3 patients), cough while swallowing (1 patient) and hematemesis (1 patient). Endoscopic findings included mid esophageal ulcer in 8 patients; submucosal tumor, 2; mid esophageal mass, 2; mass lesion at GE junction, 1; and a fistula communicating with the bronchus, 1. Chest CT scan revealed enlarged necrotic mediastinal lymph nodes in 10 cases. The biopsy and/or cytological specimens showed acid-fast bacilli, granuloma or both in 13 patients. All patients were administered antituberculous treatment; 1 patient required surgery. All patients revealed healing of lesions on repeat endoscopy. Conclusion: Dysphagia was the commonest presentation. Ten (71.4%) patients had associated enlarged necrotic mediastinal lymph nodes. Histological and/or microbiological proof was obtained in 13 of 14 (92.8%) cases. Thirteen patients responded to antituberculous therapy and 1 patient required surgery. (J Dig Endosc 2010;1:14-18)