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Interesting case of spontaneously resolved dysphagia in a young female due to complicated esophageal tuberculosis

Dhaval Choksi, Alisha Chaubal, Ruchir Patel, Chetan Rathi, Meghraj Ingle, Prabha Sawant
  • Dhaval Choksi
    Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India | dhavalrchoksi@gmail.com
  • Alisha Chaubal
    Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India
  • Ruchir Patel
    Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India
  • Chetan Rathi
    Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India
  • Meghraj Ingle
    Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India
  • Prabha Sawant
    Department of Gastroenterology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai, India

Abstract

Mycobacterium tuberculosis can affect any organ of the body. Gastrointestinal tubercular involvement is fairly common. Esophageal tuberculosis though is uncommon. Esophageal tuberculosis accounts for only 0.3% of gastrointestinal tuberculosis. It presents with dysphagia, retrosternal pain, cough or constitutional symptoms. Complications like hemorrhage from the ulcer and development of fistulas like esophagomediastinal fistula is extremely uncommon. We report a case of a 27 years old female who presented with retrosternal pain, dysphagia and hematemesis. The patient had esophageal ulcer secondary to erosion of the esophagus by the subcarinal lymph nodes. Imaging was suggestive of esophagomediastinal fistula. Esophageal ulcer biopsy showed chronic tubercular infection. Culture from the esophageal biopsy confirmed the presence of tubercular bacilli. Patient responded to anti-tubercular therapy. Spontaneous dysphagia resolution prior to starting therapy was likely due to the rupture of the lymph node into the esophagus, which was compressing it initially. Esophageal tuberculosis presenting with hematemesis and fistula is extremely uncommon.

Keywords

Esophageal tuberculosis, esophagomediastinal fistula

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Submitted: 2016-11-15 21:01:39
Published: 2017-11-22 14:08:33
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Copyright (c) 2017 Dhaval Choksi, Alisha Chaubal, Ruchir Patel, Chetan Rathi, Meghraj Ingle, Prabha Sawant

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