Oesophageal Tuberculosis - Rare case series report

Introduction. The rarest form of G.I.T. Tuberculosis is Oesopahageal Tuberculosis. It can present as primary or secondary forms. Incidence of primary and secondary Tuberculosis accounts for 0.15 and 0.14 respectively.Its clinical presentation is easily confused with that of Malignancy.Oesophageal TB usually cured with ATT without sequelae even in the presence of tracheoesophageal fistula. Here we report 2 cases of oesophageal tuberculosis Case 1 - 46yr old female presented with Dysphagia Grade 2 of one month duration along with history of food held up in chest.Chest Xray and CT chest - Normal study. UGI Scopy revealed eccentricaly placed large excavating ulcer with overhanging edges at 22cm of oesophagus. Biopsy revealed epitheloid granuloma and caseating necrosis suggestive of tuberculosis.Case 2 - 28yrs old female presented with Dysphagia Gr1-2 of 15days duration which was progressive in nature associated with retrosternal discomfort. OGD revealed globular eccentricaly placed submucosal lesion at 25cm with superficial ulceration on endoscopy .CT chest showed Hypodense subcarinal mass,possible a nodal mass involving the oesophageal wall.EUS guided FNAC from lesion showed features suggestive of tuberculosis. Both the Patients were put on ATT for 6months and their symtoms improved well with treatment. Conclusion Oesophageal Tuberculosis though its a rare entity could have many fold presentation like ulceration,stricture,and a differential diagnosis of tuberculosis to be kept in mind in any ulcerovegetative lesions of Oesophagus and ATT should be considered earliest .