Gomes Joana, Antunes Ana, Carvalho Aurora, Duarte Raquel
Centro Hospitalar de Gaia/Espinho, EPE, Rua Conceição Fernandes 4434-502 Vila Nova de Gaia, Portugal.
J Med Case Rep. 2011 Sep 8;5:447. doi: 10.1186/1752-1947-5-447.
Esophageal involvement by Mycobacterium tuberculosis is rare and the diagnosis is frequently made by means of an esophageal biopsy during the evaluation of dysphagia. There are few cases reported in the literature.
We present two cases of esophageal tuberculosis in 85- and 65-year-old male Caucasian patients with initial complaints of dysphagia and epigastric pain. Upper gastrointestinal endoscopy resulted in the diagnosis of esophageal tuberculosis following the biopsy of lesions of irregular mucosa in one case and a sessile polyp in the other. Pulmonary tuberculosis was detected in one patient. In one patient esophageal stricture developed as a complication. Antituberculous therapy was curative in both patients.
Although rare, esophageal tuberculosis has to be kept in mind in the differential diagnosis of dysphagia. Pulmonary involvement has important implications for contact screening.
结核分枝杆菌累及食管的情况罕见,诊断通常是在评估吞咽困难时通过食管活检做出。文献中报道的病例很少。
我们报告两例食管结核病例,患者为85岁和65岁的白种男性,最初表现为吞咽困难和上腹部疼痛。上消化道内镜检查在一例中对不规则黏膜病变进行活检,另一例对无蒂息肉进行活检后确诊为食管结核。其中一名患者检测出肺结核。一名患者出现食管狭窄并发症。两名患者接受抗结核治疗均治愈。
尽管罕见,但在吞咽困难的鉴别诊断中必须考虑食管结核。肺部受累对接触者筛查具有重要意义。