Bronchoesophageal Fistula due to Esophageal Tuberculosis

Desai, Pathik; Mayenkar, Prachi; Northrup, Thomas F.; Mallela, Vijaya

doi:10.1155/2019/6537437

Cited by 6 publications

(5 citation statements)

References 11 publications

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“…[ 48 59 ] Complications in the form of abscesses, stricture, perforation, bleeding and fistulas to adjacent structures like trachea, bronchi, mediastinum and aorta may be the presenting features of OTB. [ 48 57 58 59 60 61 62 ]…”

Section: Clinical Featuresmentioning

confidence: 99%

Gastrointestinal tuberculosis

Alzanbagi¹,

Shariff²

2021

Saudi Journal of Gastroenterology

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Tuberculosis (TB) once considered a disease of the developing world is infrequent in the developing world too. Its worldwide prevalence with a huge impact on the healthcare system both in economic and health terms has prompted the World Health Organization to make it a top priority infectious disease. Tuberculous infection of the pulmonary system is the most common form of this disease, however, extrapulmonary TB is being increasingly recognized and more often seen in immunocompromised situations. Gastrointestinal TB is a leading extrapulmonary TB manifestation that can defy diagnosis. Overlap of symptoms with other gastrointestinal diseases and limited accuracy of diagnostic tests demands more awareness of this disease. Untreated gastrointestinal TB can cause significant morbidity leading to prolonged hospitalization and surgery. Prompt diagnosis with early initiation of therapy can avoid this. This timely review discusses the epidemiology, risk factors, pathogenesis, clinical presentation, current diagnostic tools and therapy.

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Section: Clinical Featuresmentioning

confidence: 99%

Gastrointestinal tuberculosis

Alzanbagi¹,

Shariff²

2021

Saudi Journal of Gastroenterology

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“…Few patients have typical tubercular symptoms, such as low fever, fatigue and weight loss [ 18 , 19 ]. Uncommon presentations, such as hematemesis [ 24 ], perforation [ 25 ] and fistula-related symptoms [ 26 ], can also be found in previous studies. Endoscopic presentations of ET are variable, including ulceration, protruding lesions and fistulae, causing ET to be easily misdiagnosed as esophageal carcinoma or SMTs.…”

Section: Discussionmentioning

confidence: 83%

“…Akazaki and Inagaki in Japan reported that dust-disposing cells can play crucial roles not only in the process of depositing dust in the lung but also in the fight against invading tubercle bacilli, and the appearance of both pneumoconiotic and tuberculous lesions in the same location seems to accelerate the aggravation of tuberculous complications [ 26 ]. This may imply the possibility that the dust-disposing cells aggregate to defend against tuberculosis.…”

Section: Discussionmentioning

confidence: 99%

Esophageal anthracosis occurred after treatment of esophageal tuberculosis secondary to mediastinal tuberculous lymphadenitis: a rare case report

Cheng

Zhou

et al. 2023

BMC Infect Dis

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Background Anthracosis is a disease generally considered to be in the lungs resulting from exposure to industrial dust in the workplace. Esophageal anthracosis is a fairly rare phenomenon and shows a strong correlation with tuberculosis. Moreover, esophageal involvement in tuberculosis is also rare. We here present an extremely rare case in which follow-up gastroesophageal endoscopy revealed a mass with a sunken, black area in the center and raised ring-like pattern in the surrounding mucosa resembling malignant melanoma. Uncovering the patient’s tuberculosis history finally avoided a misdiagnosis or overtreatment. Case presentation A 67-year-old male patient was admitted to the hospital due to “repeated chest pain for 1 month”. Endoscopic ultrasonography and contrast-enhanced CT scans revealed a mass adjacent to the esophageal wall with unclear boundaries. Aspiration biopsy confirmed that esophageal tuberculosis was caused by nearby mediastinal tuberculous lymphadenitis. After a standard anti-tuberculosis treatment regimen, the patient achieved a favorable prognosis. The follow-up gastroesophageal endoscopy showed a sunken black lesion with elevated peripheral mucosa replacing the original tuberculous mass, which was thought to be anthracosis, a disease that rarely occurs in the esophagus. Conclusion The diagnosis of tuberculosis should be taken into consideration when a submucosal mass appears in the middle part of the esophagus. Endoscopic ultrasonography can effectively contribute to a definite diagnosis. Moreover, this is the first case of esophageal anthracosis observed only 1 year after the treatment of tuberculosis, indicating esophageal anthracosis can be a short-term disease. The traction of the reduction of tubercular mediastinal lymph nodes after anti-tuberculosis treatment may create a circumstance for pigmentation or dust deposition.

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“… 7 , 8 Congenital BEF is mostly found in childhood and is very rare in adults. 9 There have been reports of BEF due to esophageal tuberculosis, 10 and recently, BEF has been reported in patient with coinfection of severe acute respiratory syndrome coronavirus 2 and tuberculosis. 11 In patients with CD, there have been some cases of BEF due to esophageal involvement, 12 although esophageal involve ment in CD is rare and is reportedly difficult to diagnose.…”

Section: Discussionmentioning

confidence: 99%

Bronchoesophageal fistula in a patient with Crohn’s disease receiving anti-tumor necrosis factor therapy

Choi

Kim

et al. 2023

Clin Endosc

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Tuberculosis is an adverse event in patients with Crohn’s disease receiving anti-tumor necrosis factor (TNF) therapy. However, tuberculosis presenting as a bronchoesophageal fistula (BEF) is rare. We report a case of tuberculosis and BEF in a patient with Crohn’s disease who received anti-TNF therapy. A 33-year-old Korean woman developed fever and cough 2 months after initiation of anti-TNF therapy. And the symptoms persisted for 1 months, so she visited the emergency room. Chest computed tomography was performed upon visiting the emergency room, which showed BEF with aspiration pneumonia. Esophagogastroduodenoscopy with biopsy and endobronchial ultrasound with transbronchial needle aspiration confirmed that the cause of BEF was tuberculosis. Anti-tuberculosis medications were administered, and esophageal stent insertion through endoscopy was performed to manage the BEF. However, the patient’s condition did not improve; therefore, fistulectomy with primary closure was performed. After fistulectomy, the anastomosis site healing was delayed due to severe inflammation, a second esophageal stent and gastrostomy tube were inserted. Nine months after the diagnosis, the fistula disappeared without recurrence, and the esophageal stent and gastrostomy tube were removed.

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Bronchoesophageal Fistula due to Esophageal Tuberculosis

Cited by 6 publications

References 11 publications

Gastrointestinal tuberculosis

Gastrointestinal tuberculosis

Esophageal anthracosis occurred after treatment of esophageal tuberculosis secondary to mediastinal tuberculous lymphadenitis: a rare case report

Bronchoesophageal fistula in a patient with Crohn’s disease receiving anti-tumor necrosis factor therapy

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