Pulmonary findings in patients with chagasic megaesophagus. Study of autopsied cases

We studied retrospectively 69 cases of chagasic megaesophagus (group 1) and 207 cases of chronic chagasic myocardiopathy (CCM) without megaesophagus (group 2) by autopsy in the Pathology Department of the Federal University of Bahia, Brazil, from 1953 to 1975. It was shown that pulmonary tuberculosis was significantly more frequent in group 1 (21.7 percent) than in group 2 (3.4 percent). The patients of group 1, who had megaesophagus without associated cardiomyopathy (n = 36), had a much higher rate of pulmonary tuberculosis (36.1 percent) than those with associated CCM (6.0 percent), and they also had the most severe forms of the pulmonary disease. Other pulmonary complications of infectious origin occurred more frequently in group 1. The prevalence of pneumonia was 34.7 percent in group 1 and 10 percent in group 2. Six cases were considered to be aspiration pneumonia. Long abscess occurred in two cases in each group. We suggest that megaesophagus should be carefully investigated for pulmonary complications, especially for tuberculosis in populations with a high rate of this infection.