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Tuberculous esophagitis with aortic aneurysm fistula
1Department of Cardiovascular-Thoracic Surgery, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612.
The Annals of Thoracic Surgery
|January 1, 1988
Summary
A rare case of aortoesophageal fistula caused by tuberculosis (TB) in the esophagus is presented. This complication arose in a patient with a thoracic aortic aneurysm, leading to fatal gastrointestinal bleeding.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Cardiovascular Surgery
Background:
- Tuberculosis (TB) can manifest in various organs, including the esophagus.
- Thoracic aortic aneurysms are serious vascular conditions.
- Aortoesophageal fistulas are rare but life-threatening complications.
Observation:
- A patient with a history of pulmonary TB and a thoracic aortic aneurysm presented with dysphagia.
- Barium swallow showed an esophageal mass and mediastinal contrast extravasation.
- Endoscopy and biopsy confirmed acid-fast organisms in the esophagus.
Findings:
- The patient developed a fatal aortoesophageal fistula.
- Histopathology confirmed a tuberculous esophageal lesion as the cause of the fistula.
- Antituberculous therapy preceded massive gastrointestinal bleeding.
Implications:
- This case highlights a rare but critical complication of esophageal tuberculosis.
- Early recognition and management of aortoesophageal fistulas are crucial.
- Tuberculosis should be considered in the differential diagnosis of esophageal lesions, especially in at-risk populations.