Tuberc Respir Dis.  2007 Jun;62(6):531-535.

A Case of Esophago-mediatinal Fistula Due to Esophageal Tuberculosis

• Park EH
• Jang TW
• Park MI
• Song JY
• Choi IS
• Oak CH
• Jung MH
• Kwon JH

Abstract

The esophagus is a rate site for rarely involved site of tuberculosis. The most common cause of esophageal tuberculosis is secondary involvement from adjacent tuberculous lymphadenitis. Esophago-nodal or esophagobronchial fistulas may be formed when tuberculous lymph nodes erode the adjacent esophageal or bronchial wall. We report a patient diagnosed with esophageal tuberculosis, which was complicated by an esophago-mediastinal fistula, by endoscopy, sputum acid fast bacilli (AFB) stain, chest computed tomography (CT), and an esophagogram. The patient was treated with antituberculous agents and chest CT and endoscopy showed that the fistula had closed completely.

Keyword

Tuberculosis; Esophagus-mediastinum

MeSH Terms

Cytochrome P-450 CYP1A1
Endoscopy
Esophagus
Fistula*
Humans
Lymph Nodes
Sputum
Thorax
Tomography, X-Ray Computed
Tuberculosis*
Tuberculosis, Lymph Node
Cytochrome P-450 CYP1A1

Figure

• 

  Figure 1 This radiographic study of chest shows multiple no-dular opacities in left upper zone. Perihilar engorgement is suspicious.

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  Figure 2 A 3 × 2 cm sized roundly deep ulce-rative lesion with fistular opening was noted at 33 cm site from upper incisor.

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  Figure 3 Esophagogram shows an irregular barium leakage outline the fistular in mid esophagus.

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  Figure 4 Contrast enhanced CT scan shows linear or oval gas collections in an enlarged left lower paratracheal lymph node. There is a communication between the esophagus and a mediastinal area of air attenuation and peripheral rim enhancement and calcified right lower lymph node.

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  Figure 5 Shallow ulceration at left lateral wall of mid esophagus. No evidence of mediastinal leakage.

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  Figure 6 A shallow well demarcated defect with tiny fistulous opening was noted. Much improving state comparing with previous study.

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  Figure 7 Follow up contrast enhanced CT scan show no abnormal air collection in mediastinum.

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