肺结核作为食管狭窄的主要病因：一例病例报告。
Tuberculosis as a primary cause of oesophageal stricture: a case report.
作者信息
Mbiine Ronald, Kabuye Ronald, Lekuya Herve Monka, Manyillirah William
机构信息
Department of Surgery, Makerere University, Kampala, Uganda.
Uganda Heart Institute, Kampala, Uganda.
出版信息
J Cardiothorac Surg. 2018 Jun 5;13(1):58. doi: 10.1186/s13019-018-0743-4.
BACKGROUND
Tuberculous (TB) oesophagitis is a rare manifestation of dysphagia occurring in 0.3% of all gastro-intestinal tract TB infections as well as 0.15% of all cases of dysphagia and often is misdiagnosed. This report presents a rare manifestation of TB as a cause of oesophageal stricture.
CASE PRESENTATION
We describe a rare presentation of a patient with grade IV dysphagia due to an oesophageal stricture. Oesophagoscopy revealed a pinhole stricture with evidence of high grade dysplasia on histology. Subsequently an Ivor-Lewis oesophagectomy was performed and histology revealed evidence of active oesophageal tuberculosis. The patient had an uneventful recovery and completed anti-TB medication.
CONCLUSIONS
Oesophageal TB is a rare but curable cause of dysphagia. It may mimic cancer of the oesophagus and it is usually missed as a possible cause of oesophageal strictures. There needs to be an increased index of suspicion among patients with dysphagia in TB endemic regions.
背景
结核性食管炎是吞咽困难的一种罕见表现，在所有胃肠道结核感染病例中占0.3%，在所有吞咽困难病例中占0.15%，且常被误诊。本报告介绍了一种罕见的结核表现形式，即食管狭窄的病因。
病例介绍
我们描述了一名因食管狭窄导致IV级吞咽困难的罕见病例。食管镜检查发现一个针孔样狭窄，组织学检查显示有高级别发育异常的证据。随后进行了Ivor-Lewis食管切除术，组织学检查显示有活动性食管结核的证据。患者恢复顺利，完成了抗结核治疗。
结论
食管结核是吞咽困难的一种罕见但可治愈的病因。它可能酷似食管癌，通常会被漏诊为食管狭窄的可能病因。在结核病流行地区，吞咽困难患者的怀疑指数需要提高。
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