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Related Experiment Videos

Asymptomatic spinal tuberculosis presenting as esophageal stricture

M S Bhatnagar1, S A Nanivadekar, P Sawant

  • 1Department of Gastroenterology, LTMG Hospital & LTM Medical College, Bombay.

Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology
|April 1, 1996
PubMed
Summary

Esophageal tuberculosis, a rare condition, can cause esophageal strictures. This case highlights the importance of considering tuberculosis in dysphagia diagnosis, even with non-specific biopsies, as the patient responded well to anti-tubercular therapy.

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Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Pulmonology

Background:

  • Esophageal tuberculosis (ETB) is an uncommon manifestation of Mycobacterium tuberculosis infection.
  • It typically arises from direct extension from adjacent infected structures, such as the trachea or lymph nodes.
  • Accurate diagnosis can be challenging due to nonspecific symptoms and endoscopic findings.

Observation:

  • A patient presented with dysphagia, indicating difficulty swallowing.
  • Esophageal stricture was identified as the cause of dysphagia.
  • Initial endoscopic biopsies were inconclusive for malignancy or tuberculosis.
  • Thoracic computed tomography (CT) revealed involvement of the fourth thoracic vertebra and paratracheal lymphadenopathy.

Findings:

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  • The CT findings suggested a contiguous spread of infection, consistent with tuberculosis.
  • Despite non-diagnostic initial biopsies, the clinical presentation and imaging were suggestive of ETB.
  • The patient showed significant improvement after initiating anti-tubercular therapy.

    • Implications:

    • This case underscores the importance of considering ETB in the differential diagnosis of esophageal strictures, particularly in endemic areas.
    • Advanced imaging like CT can be crucial for identifying underlying tuberculous involvement when biopsies are non-diagnostic.
    • Prompt diagnosis and treatment of ETB can lead to favorable outcomes and prevent complications.