Ramesh, N (2014) Management of Esophageal Tuberculosis: A Single center experience. Masters thesis, Madras Medical College, Chennai.
|
Text
180600114ramesh.pdf Download (1MB) | Preview |
Abstract
INTRODUCTION : Even in countries with a high incidence of tuberculosis, esophageal tuberculosis is a rare diagnosis. Esophageal tuberculosis is considered primary when there is no other detectable tuberculous site and secondary when the esophagus is involved by spread from adjacent organs or by hematogenous spread from a distant site. The natural history, clinical and endoscopic features, complications, and treatment of this condition is often unclear. We present our experience with Esophageal tuberculosis encountered From Nov 2011 to March 2014 and highlight the tendency of esophageal tuberculosis to form an ulcerovegetative lesion thereby mimicking a neoplastic process. All the patients who were diagnosed and treated for esophageal tuberculosis who were on follow up in our study period were also included. AIM OF THE STUDY : To study the demography, clinical features, endoscopic findings, radiographic abnormalities and outcome of antituberculous treatment with or with-out surgery for tuberculosis of the esophagus. To analyze the role of surgical therapy in managing this disease. METHODS : In our analyses, tuberculosis presenting with dysphagia can be broadly categorized into an ulcer group (UG, n=21) and an extrinsic compression group (n=10). The ulcerative form of ET which is often misdiagnosed as malignancy is reviewed. History and physical findings were noted. Chest radiographs, Upper GI endoscopy (including biopsies of esophageal lesions), biopsies or FNA cytology of lymph nodes, bronchoscopy, contrast esophagogram, and thoracic CT were performed. Diagnosis was made with histological proof of epithelioid cell granulomas with marginally polygonal Langhans-type giant cells and/or the presence of acid-fast bacilli. CONCLUSION : This study shows that esophageal involvement is not isolated in most patients. Dysphagia due to tuberculosis can be due to ulcerative lesions or extraluminal compression due to lymphadenopathy. It is not uncommon to find esophageal tuberculosis misdiagnosed as malignancy during endoscopy. Tuberculous involvement was confirmed by pathological examination in all patients. Although antituberculous therapy is the mainstay of treatment, surgery is reserved for complications and persistent fistula despite adequate therapy.
| Item Type: | Thesis (Masters) |
|---|---|
| Uncontrolled Keywords: | Esophageal Tuberculosis ; Management Single center experience. |
| Subjects: | MEDICAL > Surgical Gastroenterology and Proctology |
| Depositing User: | Kambaraman B |
| Date Deposited: | 27 Jul 2017 03:46 |
| Last Modified: | 27 Jul 2017 03:56 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/2223 |
Actions (login required)
 |
View Item |
