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Oesophageal Tuberculosis

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A patient who had experienced pain when swallowing for a couple of months. This is the finding in the upper third of the oesophagus.

The finding after 6 weeks of treatment with a high dose proton pump inhibitor. There is an obvious progression of the lesion, the treatment being ineffective. Mycobacterium tuberculis was found in the stomach juice and histopathologic examination of the biopsies was suggestive of tuberculosis at this time.

The endoscopic finding in the same region after two months of multidrug antituberculous chemotherapy. The tuberculous ulcer is cured, only a slight scarring is left to be seen, and the patient was free of symptoms.

Primary oesophageal tuberculosis has been considered to be a very rare disease. Almost every other organ of our body is more readily infected by Mycobacterium tuberculosis than the oesophagus. Less than 1 % of all cases of tuberculosis involve the oesophagus. There have been descriptions of three types of tuberculous oesophagitis, the ulcerative type, the hypertrophic or hyperplastic type and the granular type. The pictures above represent the ulcerative type, which is the most common type. Pain when swallowing, odynophagia, is the typical symptom of this type. Modern multidrug tuberculosis treatment usually cure this disease.

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December 5, 2011