Oesophageal Tuberculosis - Rare case series report

Abstract

Introduction. The rarest form of G.I.T. Tuberculosis
is Oesopahageal Tuberculosis.
It can present as primary or secondary
forms. Incidence of primary and
secondary Tuberculosis accounts for
0.15 and 0.14 respectively.Its clinical
presentation is easily confused with that
of Malignancy.Oesophageal TB usually
cured with ATT without sequelae even in
the presence of tracheoesophageal fistula.
Here we report 2 cases of oesophageal
tuberculosis Case 1 - 46yr old
female presented with Dysphagia Grade
2 of one month duration along with history
of food held up in chest.Chest Xray
and CT chest - Normal study. UGI Scopy
revealed eccentricaly placed large excavating
ulcer with overhanging edges at
22cm of oesophagus. Biopsy revealed
epitheloid granuloma and caseating necrosis
suggestive of tuberculosis.Case 2
- 28yrs old female presented with Dysphagia
Gr1-2 of 15days duration which
was progressive in nature associated
with retrosternal discomfort. OGD revealed
globular eccentricaly placed submucosal
lesion at 25cm
with superficial ulceration on endoscopy
.CT chest showed Hypodense subcarinal
mass,possible a nodal mass involving
the oesophageal wall.EUS guided
FNAC from lesion showed features suggestive
of tuberculosis. Both the Patients
were put on ATT for 6months and their
symtoms improved well with treatment.
Conclusion Oesophageal Tuberculosis
though its a rare entity could have many
fold presentation like ulceration,
stricture,and a differential diagnosis of
tuberculosis to be kept in mind in any ulcerovegetative
lesions of Oesophagus and
ATT should be considered earliest .