未经证实:食管结核是一种相对少见的疾病。大多数情况下,食管可通过直接扩散或纵隔淋巴结(很少来自肺或血流)受到结核的影响。最常见的症状是吞咽困难,诊断通过组织学证实。如果不及时治疗,食管结核会导致出血,穿孔,瘘管形成,吸入性肺炎,致死性呕血,牵引憩室,和食管狭窄.
方法:这是一例罕见的由肺结核引起的食管瘘病例,患者在进食时出现咳嗽和体重减轻。患者接受了上消化道内镜检查,显示距离上中央切牙20厘米的颈食管瘘。组织病理学显示炎性病变伴上皮样肉芽肿(肉芽肿病)。进行了痰分枝杆菌检查;涂片为阴性。患者接受了抗结核治疗(ATT)的保守治疗。两个月后的随访内窥镜检查显示,瘘管闭合,临床上有所改善。
UNASSIGNED:通过协调蠕动快速清除污染的痰,与直立姿势和完整的下食管括约肌配对,限制了生物体对食道的暴露。
结论:尽管这种疾病很罕见,如果没有延迟,它可以有效地管理与ATT,以避免严重的并发症,如食管穿孔,这就需要手术。
UNASSIGNED: Esophageal TB is a relatively uncommon condition. Mostly, the esophagus can be affected by tuberculosis through direct spread or from mediastinal nodes (rarely from the lungs or bloodstream). The most common symptom is dysphagia, and the diagnosis is confirmed by histology. If left untreated, esophageal tuberculosis can result in bleeding, perforation, fistula formation, aspiration pneumonia, lethal hematemesis, traction diverticula, and esophageal strictures.
METHODS: This is a rare case report of an esophageal fistula caused by tuberculosis in a patient presenting with a cough on eating and weight loss. The patient was subjected to upper gastrointestinal endoscopy, which revealed a cervical esophagus fistula 20 cm from the upper central incisors. Histopathology revealed inflammatory lesions with epithelioid granulomas (granulomatous disease). A mycobacterium sputum examination was performed; the smear was negative. The patient was managed conservatively with anti-tuberculosis treatment (ATT). A follow-up endoscopy after two months revealed that the fistula was closed and clinically improved.
UNASSIGNED: The quick clearance of contaminated sputum by coordinated peristalsis, paired with upright posture and an intact lower esophageal sphincter, limits the organism\'s exposure to the esophagus.
CONCLUSIONS: Despite the disease\'s rarity, if not delayed, it can be efficiently managed with ATT to avoid major complications like esophageal perforation, which necessitates surgery.