Abstract
Esophageal tuberculosis is an uncommon manifestation of tuberculosis. It is an important cause of dysphagia in endemic regions and affects both genders equally. Primary involvement of the esophagus is less common. Secondary esophageal tuberculosis is usually due to esophageal involvement by the mediastinal lymph nodal tuberculosis. Dysphagia is the most common symptom followed by retrosternal pain and odynophagia. Hematemesis, although uncommon, may suggest aorto-esophageal fistula. Constitutional symptoms like weight loss, fever are seen in one-fourth of patients. Endoscopy with biopsy is the mainstay for diagnosis. Ulcer is the most common finding followed by bulge with summit ulcer which is the hallmark finding. Mid-esophagus is the most commonly involved site but the disease can involve any portion of esophagus. Endosonography has enhanced the diagnostic capability and fine-needle aspiration for cytological or histological evaluation can be done. Endoscopic ultrasound is especially useful in submucosal lesions. Esophageal tuberculosis may be complicated by fistulous communications with trachea, aorta, and skin. Antitubercular multidrug therapy is the mainstay of therapy. Sometimes additional surgical or endoscopic interventions might be warranted for the complications. Overall, esophageal tuberculosis has a good outcome with a cure rate of 92%.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Marshall JB. Tuberculosis of the gastrointestinal tract and peritoneum. Am J Gastroenterol. 1993;88(7):989–99.
Pimparkar BD. Abdominal tuberculosis. J Assoc Physicians India. 1977;25(11):801–11.
Lockard LB. Esophageal tuberculosis; A critical review. Laryngoscope. 1913;23(5):561–84.
Damtew B, Frengley D, Wolinsky E, Spagnuolo PJ. Esophageal tuberculosis: mimicry of gastrointestinal malignancy. Rev Infect Dis. 1987;9(1):140–6.
Mokoena T, Shama DM, Ngakane H, Bryer JV. Oesophageal tuberculosis: a review of eleven cases. Postgrad Med J. 1992;68(796):110–5.
Carr DT, Spain DM. Tuberculosis in a carcinoma of the Oesophagus. Am Rev Tuberc. 1942;46(3):346–9.
Cho J-K, Choi YM, Lee SS, Park HK, Cha RR, Kim WS, et al. Clinical features and outcomes of abdominal tuberculosis in southeastern Korea: 12 years of experience. BMC Infect Dis. 2018;18(1):699.
Prakasha SR, Suresh G, D’sa IP, Shetty SS, Kumar SG. Mapping the pattern and trends of Extrapulmonary tuberculosis. J Glob Infect Dis. 2013;5(2):54–9.
Dow CJ. Oesophageal tuberculosis: four cases. Gut. 1981;22(3):234–6.
Savage PE, Grundy A. Oesophageal tuberculosis: an unusual cause of dysphagia. Br J Radiol. 1984;57(684):1153–5.
Bonthala L, Wood E. Oesophageal tuberculosis. BMJ Case Rep. 2011;2011:bcr0920114883.
Fahmy AR, Guindi R, Farid A. Tuberculosis of the oesophagus. Thorax. 1969;24(2):254–6.
Khuroo MS, Khuroo NS. Abdominal Tuberculosis. In: Madkour MM, editor. Tuberculosis. Berlin: Springer; 2004. p. 659–67.
Wang Y, Zhu L, Xia W, Wang F. Anatomy of lymphatic drainage of the esophagus and lymph node metastasis of thoracic esophageal cancer. Cancer Manag Res. 2018;10:6295–303.
Han X-M, Yang J-M, Xu L-H, Nie L-M, Zhao Z-S. Endoscopic ultrasonography in esophageal tuberculosis. Endoscopy. 2008;40(08):701–2.
Montes I, Larsen E, Haiderer O, Kennedy JH. Tuberculous stricture of the esophagus: report of a patient successfully treated by colon interposition. Chest. 1971;60(2):194–5.
Eng J, Sabanathan S. Tuberculosis of the esophagus. Dig Dis and Sci. 1991;36(4):5.
Shad S, Aslam Rai A, Bux Soomro G, Hassan LN. Tuberculous Paraspinal abscess invading esophagus: a rare cause of dysphagia. J Coll Physicians Surg Pak. 2018;28(7):566–7.
Devarbhavi HC, Alvares JF, Radhikadevi M. Esophageal tuberculosis associated with esophagotracheal or esophagomediastinal fistula: report of 10 cases. Gastrointest Endosc. 2003;57(4):588–92.
O’Leary M, Nollet DJ, Blomberg DJ. Rupture of a tuberculous pseudoaneurysm of the innominate artery into the trachea and esophagus: report of a case and review of the literature. Hum Pathol. 1977;8(4):458–67.
Castro G, Módena J, Figueiredo J, Martinez R. Esophageal tuberculosis in a patient with acquired immune deficiency syndrome: a rare presentation. Endoscopy. 2006;38(Suppl 2):E27–8.
Kumar S, Minz M, Sinha SK, Vaiphei K, Sharma A, Singh S, et al. Esophageal tuberculosis with coexisting opportunistic infections in a renal allograft transplant recipient. Transpl Infect Dis. 2017;19(1):e12640.
Damaschin O, Dahmani O, Faibis F, Demachy M-C, Abtahi M, Cucherousset N, et al. Esophageal tuberculosis in a patient on maintenance dialysis: advantages of interferon-gamma release assay. Ren Fail. 2009;31(3):248–50.
Rubinstein BM, Pastrana T, Jacobson HG. Tuberculosis of the esophagus. Radiology. 1958;70(3):401–3.
Torek F. Tuberculosis of the Œsophagus. Ann Surg. 1931;94(4):794–8.
Dahale AS, Kumar A, Srivastava S, Varakanahalli S, Sachdeva S, Puri AS. Esophageal tuberculosis: uncommon of common: esophageal tuberculosis. JGH Open. 2018;2(2):34–8.
Geboes K, Janssens J, Rutgeerts P, Vantrappen G. Crohn’s disease of the esophagus. J Clin Gastroenterol. 1986;8(1):31–7.
Abraham A, Hajar R, Virdi R, Singh J, Mustacchia P. Esophageal sarcoidosis: a review of cases and an update. ISRN Gastroenterol. 2013;2013:836203.
Fritscher-Ravens A, Ghanbari A, Topalidis T, Pelling M, Kon O, Patel K, et al. Granulomatous mediastinal adenopathy: can endoscopic ultrasound-guided fine-needle aspiration differentiate between tuberculosis and sarcoidosis? Endoscopy. 2011;43(11):955–61.
Vinson PP, Dobson HE. Tuberculous stricture of the Oesophagus. Am Rev Tuberc. 1927;16(1):53–6.
Clerf LH. LXVI tuberculous Periesophageal abscess producing stenosis: report of a case. Ann Otol Rhinol Laryngol. 1940;49(3):793–6.
Fagundes RB, Dalcin RP, Rocha MP, Moraes CC, Carlotto VS, Wink MO. Esophageal tuberculosis. Endoscopy. 2007;39(Suppl 1):E149.
Takaki Y, Yao K, Yano Y, Matsui T, Tanabe H, Haraoka S, et al. Esophageal tuberculosis: a microgranuloma visualized by narrow-band imaging magnifying endoscopy. Endoscopy. 2011;43(Suppl 2):E377–8.
Park JH, Kim SU, Sohn JW, Chung IK, Jung MK, Jeon SW, et al. Endoscopic findings and clinical features of esophageal tuberculosis. Scand J Gastroenterol. 2010;45(11):1269–72.
Jain SK, Jain S, Jain M, Yaduvanshi A. Esophageal tuberculosis: is it so rare? Report of 12 cases and review of the literature. Am J Gastroenterol. 2002;97(2):287–91.
Sharma V, Rana S, Chhabra P, Sharma R, Gupta N, Bhasin D. Primary esophageal tuberculosis mimicking esophageal cancer with vascular involvement. Endosc Ultrasound. 2016;5(1):61.
Mou Y, Zeng H, Wang Q-M, Yi H, Liu W, Wen D, et al. Esophageal tuberculosis initially misdiagnosed by endoscopy as a submucosal tumor. Endoscopy. 2015;47(Suppl 1):E30-1.
Li Y-X, Nian W-D, Wang H-H. A case of esophageal tuberculosis with unusual endoscopic feature. Clin and Res Hepatol Gastroenterol. 2018;42(1):e5–6.
Seo JH, Kim GH, Jhi JH, Park YJ, Jang YS, Lee BE, et al. Endosonographic features of esophageal tuberculosis presenting as a subepithelial lesion: endoscopic ultrasound in esophageal TB. J Dig Dis. 2017;18(3):185–8.
Huang Y. Esophageal tuberculosis mimicking submucosal tumor. Interact Cardiovasc Thorac Surg. 2004;3(2):274–6.
Sood D, Singh T, Singh A, Chaudhary A. Esophageal tuberculosis mimicking submucosal leiomyoma- report of a case. Indian J Surg. 2011;73(6):465–6.
Bloomberg TJ, Dow CJ. Contemporary mediastinal tuberculosis. Thorax. 1980;35(5):392–6.
Liu C-I, Fields WR, Shaw C-I. Tuberculous mediastinal lymphadenopathy in adults. Radiology. 1978;126(2):369–71.
Amorosa JK, Smith PR, Cohen JR, Ramsey C, Lyons HA. Tuberculous mediastinal lymphadenitis in the adult. Radiology. 1978;126(2):365–8.
Aydin A, Tekin F, Ozutemiz O, Musoglu A. Value of endoscopic ultrasonography for diagnosis of esophageal tuberculosis: report of two cases. Dig Dis Sci. 2006;51(9):1673–6.
Marsman W. Dysphagia caused by esophageal tuberculosis. Neth J Med. 2001;58(2):82–5.
Rana S, Bhasin D, Rao C, Srinivasan R, Singh K. Tuberculosis presenting as dysphagia: clinical, endoscopic, radiological and endosonographic features. Endosc Ultrasound. 2013;2(2):92.
Puri R, Khaliq A, Kumar M, Sud R, Vasdev N. Esophageal tuberculosis: role of endoscopic ultrasound in diagnosis: EUS in esophageal tuberculosis. Dis Eso. 2012;25(2):102–6.
Tang Y, Shi W, Sun X, Xi W. Endoscopic ultrasound in diagnosis of esophageal tuberculosis: 10-year experience at a tertiary care center. Dis Eso. 2017;30(8):1–6.
Mohapatra PR, Janmeja AK. Tuberculous lymphadenitis. J Assoc Physicians India. 2009;57:585–90.
Fujiwara T, Yasufuku K, Nakajima T, Chiyo M, Yoshida S, Suzuki M, et al. The utility of sonographic features during endobronchial ultrasound-guided Transbronchial needle aspiration for lymph node staging in patients with lung cancer: a standard endobronchial ultrasound image classification system. Chest. 2010;138(3):641–7.
Al-Idrissi HY, Satti MB, Al-Quorain A, Ibrahim EM, Al-Fiar FZ. Granulomatous oesophagitis: a case of tuberculosis limited to the oesophagus. Ann Trop Med Parasitol. 1987;81(2):129–33.
Ch’ng EC, Hooi LN, Halimah Y, Syed J. Oesophageal tuberculosis-an unusual site for tubercular infection. Med J Malaysia. 1997;52(1):91–3.
Nagi B, Lal A, Kochhar R, Bhasin DK, Gulati M, Suri S, et al. Imaging of esophageal tuberculosis. A review of 23 cases. Acta Radiol. 2003;44(3):329–33.
Brullet E, Font B, Rey M, Ferrer A, Nogueras A. Esophageal tuberculosis: early diagnosis by endoscopy. Endoscopy. 1993;25(7):485.
Leung VKS, Chan WH, Chow TL, Luk ISC, Chau TN, Loke TKL. Oesophageal tuberculosis mimicking oesophageal carcinoma. Hong Kong Med J. 2006 Dec;12(6):473–6.
Harish K, Gokulan C. Primary oesophageal tuberculosis: a rare entity. Trop Gastroenterol. 2007;28(4):178–9.
Fujiwara T, Yoshida Y, Yamada S, Kawamata H, Fujimori T, Imawari M. A case of primary esophageal tuberculosis diagnosed by identification of mycobacteria in paraffin-embedded esophageal biopsy specimens by polymerase chain reaction. J Gastroenterol. 2003;38(1):74–8.
Fujiwara Y, Osugi H, Takada N, Takemura M, Lee S, Ueno M, et al. Esophageal tuberculosis presenting with an appearance similar to that of carcinoma of the esophagus. J Gastroenterol. 2003;38(5):477–81.
Musoğlu A, Ozütemiz O, Tekin F, Aydin A, Savaş R, Ilter T. Esophageal tuberculosis mimicking esophageal carcinoma. Turk J Gastroenterol. 2005;16(2):105–7.
Peixoto PC, Ministro PS, Sadio AD, Cancela EM, Araújo RN, Machado JL, et al. Esophageal tuberculosis: an unusual cause of dysphagia. Gastrointest Endosc. 2009;69(6):1173–6.
Welzel TM, Kawan T, Bohle W, Richter GM, Bosse A, Zoller WG. An unusual cause of dysphagia: esophageal tuberculosis. J Gastrointestin Liver Dis. 2010;19(3):321–4.
Khanna V, Kumar A, Alexander N, Surendran P. A case report on esophageal tuberculosis – a rare entity. Int J Surg Case Rep. 2017;35:41–3.
Khan MS, Maan MHA, Sohail AH, Memon WA. Primary esophageal tuberculosis mimicking esophageal carcinoma on computed tomography: a case report. World J Gastrointest Surg. 2019;11(9):373–80.
Jain SS. Esophageal tuberculosis presenting with hematemesis. World J Gastrointest Endosc. 2013;5(11):581.
Changal KH, AbH R, Parra R, Khan MA. Esophageal tuberculosis; a rare cause of odynophagia: a case report. Egypt J Chest Dis Tuberc. 2013;62(2):349–51.
Prasant P, Kajal N, Dadra R, Nithin K, Kaur J. Esophageal tuberculosis: a rare case report. Int J Mycobacteriol. 2019;8(4):409.
Sasikumar C, Utpat K, Desai U, Joshi JM. Esophagomediastinal fistula presenting as drug resistant tuberculosis. Ind J Tuberc. 2020;67(3):363–5.
Madi D. An interesting case of dysphagia in a HIV patient. J Clin Diagn Res. 2013;7(3):534–6.
de Silva R, Stoopack PM, Raufman JP. Esophageal fistulas associated with mycobacterial infection in patients at risk for AIDS. Radiology. 1990;175(2):449–53.
Allen CM, Craze J, Grundy A. Case report: tuberculous broncho-oesophageal fistula in the acquired immunodeficiency syndrome. Clin Radiol. 1991;43(1):60–2.
Baijal R, Ramegowda PKH, Jain M, Gupta D, Shah N, Kulkarni S. Clinical profile and management of tuberculous bronchoesophageal fistula. J Dig Endosc. 2013;04(04):103–6.
Wigley FM, Murray HW, Mann RB, Saba GP, Kashima H, Mann JJ. Unusual manifestation of tuberculosis: TE fistula. Am J Med. 1976;60(2):310–4.
Abid S, Jafri W, Hamid S, Khan H, Hussainy A. Endoscopic features of esophageal tuberculosis. Gastrointest Endosc. 2003;57(6):759–62.
Rosario MT, Raso CL, Comer GM. Esophageal tuberculosis. Dig Dis Sci. 1989;34(8):4.
McNamara M, Williams CE, Brown TS, Gopichandran TD. Tuberculosis affecting the oesophagus. Clin Radiol. 1987;38(4):419–22.
Desai P, Mayenkar P, Northrup TF, Mallela V. Bronchoesophageal fistula due to esophageal tuberculosis. Case Rep Infect Dis. 2019;2019:1–3.
Hancock BW, Barnett DB. Case of post-primary tuberculosis and massive haematemesis. Br Med J. 1974;3(5933):722–3.
Amonkar GP, Vaideeswar P, Metkar GS. Oesophageal rupture due to tuberculous pseudoaneurysm of the aorta. J Clin Pathol. 2009;62(7):671.
Catinella FP, Kittle CF. Tuberculous esophagitis with aortic aneurysm fistula. Ann Thorac Surg. 1988;45(1):87–8.
Ni B, Lu X, Gong Q, Zhang W, Li X, Xu H, et al. Surgical outcome of esophageal tuberculosis secondary to mediastinal lymphadenitis in adults: experience from single center in China. J Thorac Dis. 2013;5(4):8.
Desai RRP, Keny S, Lawande D. Tubercular esophagocutaneous fistula: rare case report. Indian J Tuberc. 2018;65(2):177–9.
Hajong R, Topno N, Baruah AJ, Das R. Tubercular Esophagocutaneous Fistula. Indian J Surg. 2013;75(S1):6–8.
Vinodh BN, Sharma SK, Smith-Rohrberg D, Seith A. Tubercular oesophagocutaneous fistula. Indian J Chest Dis Allied Sci. 2006;48(3):209–11.
Pellegrini VM. Case of esophageal tuberculosis treated with streptomycin. Arch Ital Otol Rinol Laringol. 1950;61(6):634–8.
World Health Organization. Guidelines for treatment of drug-susceptible tuberculosis and patient care: 2017 update. 2017.
Fang H-Y, Lin T-S, Cheng C-Y, Talbot AR. Esophageal tuberculosis: a rare presentation with massive hematemesis. Ann Thorac Surg. 1999;68(6):2344–6.
Mbiine R, Kabuye R, Lekuya HM, Manyillirah W. Tuberculosis as a primary cause of oesophageal stricture: a case report. J Cardiothorac Surg. 2018;13(1):58.
Baijal R, Agal S, Amarapurkar DN, Hr PK, Kotli N, Jain M. Esophageal tuberculosis: an analysis of fourteen cases. J Dig Endosc. 2010;1:14–8.
Alataş F, Özdemir N, Işıksoy S, Metintaş M, Erginel S, Harmancı E, et al. An unusual case of esophageal tuberculosis in an adult. Respiration. 1999;66(1):88–90.
Eroğlu A, Kürkçüoğlu C, Karaoğlanoğlu N, Yilmaz Ö, Gürsan N. Esophageal tuberculosis abscess: an unusual cause of dysphagia. Dis Eso. 2002;15(1):93–5.
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Ethics declarations
None
Rights and permissions
Copyright information
© 2022 The Author(s), under exclusive license to Springer Nature Singapore Pte Ltd.
About this chapter
Cite this chapter
Dahale, A.S., Kumar, A., Srivastava, S. (2022). Esophageal Tuberculosis. In: Sharma, V. (eds) Tuberculosis of the Gastrointestinal system. Springer, Singapore. https://doi.org/10.1007/978-981-16-9053-2_4
Download citation
DOI: https://doi.org/10.1007/978-981-16-9053-2_4
Published:
Publisher Name: Springer, Singapore
Print ISBN: 978-981-16-9052-5
Online ISBN: 978-981-16-9053-2
eBook Packages: MedicineMedicine (R0)