Korean J Med.
2018 Oct;93(5):477-481. 10.3904/kjm.2018.93.5.477.
Esophago-Mediastinal Fistula Due to Tuberculous Mediastinal Lymphadenitis
- Affiliations
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- 1Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
- 2Department of Gastroenterology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. dohoon.md@gmail.com
- KMID: 2446991
- DOI: http://doi.org/10.3904/kjm.2018.93.5.477
Abstract
- Tuberculosis rarely involves the esophagus, and most esophageal tuberculosis occurs secondary to adjacent tuberculous lymphadenitis. An esophago-mediastinal fistula is a very unusual complication of tuberculous lymphadenitis. Herein, we report a case of an esophago-mediastinal fistula due to tuberculous lymphadenitis. A 28-year-old woman who had dysphagia was assessed by chest computed tomography, endoscopy, esophagogram, and a lymph node biopsy. An esophago-mediastinal fistula was found and an antituberculous agent was considered initially. However, because of her severe dysphagia, she managed with endoscopic clipping as an alternative. However, the fistula remained on follow-up esophagography. A gastrostomy was eventually performed, and she was treated with an antituberculous agent. The fistula had closed after 4 weeks of medication. Antituberculous agents are the mainstay treatment for esophago-mediastinal fistula due to tuberculous lymphadenitis; endoscopic clipping may be a complementary treatment.
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