Abid Shahab, Jafri Wasim, Hamid Saeed, Khan Haleem, Hussainy Akbar
Section of Gastroenterology, Department of Medicine, Aga Khan University, Karachi, Pakistan.
Gastrointest Endosc. 2003 May;57(6):759-62. doi: 10.1067/mge.2003.205.
Esophageal tuberculosis is rare. Clinical and endoscopic features are variable, diverse, nonspecific, and poorly described. These findings may be confused with those of esophageal cancer and deep fungal infection.
Medical records from a 5-year period (January 1997 to December 2001) were searched for cases of esophageal tuberculosis. For identified cases, the clinical, radiologic, and endoscopic features were evaluated.
Four cases of esophageal tuberculosis were encountered during the 5-year period studied. Three of the patients presented with dysphagia and weight loss. One patient had aspiration pneumonia and another fatal hematemesis. Endoscopic features included deep and large proximal esophageal ulcers in 2 patients, tracheo-esophageal fistula in one, and nonhealing proximal esophageal ulcer in another patient.
The present case series indicates that certain endoscopic features, such as deep and large esophageal ulcers, tracheoesophageal fistula, and nonhealing ulcer, are strongly suggestive of tuberculosis-related esophageal lesions.
食管结核较为罕见。其临床和内镜特征多变、多样、非特异性且描述欠佳。这些表现可能会与食管癌和深部真菌感染的表现相混淆。
检索了5年期间（1997年1月至2001年12月）的病历以查找食管结核病例。对于确诊病例，评估其临床、放射学和内镜特征。
在所研究的5年期间共遇到4例食管结核病例。3例患者表现为吞咽困难和体重减轻。1例患者发生吸入性肺炎，另1例出现致命性呕血。内镜特征包括2例患者食管近端有深大溃疡，1例有气管食管瘘，另1例患者食管近端溃疡不愈合。
本病例系列表明，某些内镜特征，如食管深大溃疡、气管食管瘘和不愈合溃疡，强烈提示与结核相关的食管病变。
