[Case of solitary tuberculous ulcer of the small intestine].
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A case of tuberculous involvement of the esophagus was studied in an adult with mediastinal lymphadenopathy unrecognized by roentgenography of the chest. The roentgenographic and endoscopic features in this case were more consistent with malignancy than with tuberculosis. Nineteen additional cases from the English-language literature were reviewed. Although esophageal tuberculosis is a rare disease, it should be strongly suspected in a patient with dysphagia who has a positive tuberculin skin test, active pulmonary disease, or mediastinal adenopathy.
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Among 126 patients with gastrointestinal tract tuberculosis (GITT), 54.0% of cases developed GITT with involvement of the lung, by preceding the latter in 16.7%; concomitantly with the latter in 13.5%, and by following it in 23.8%; in addition to pulmonary affection, GITT was concurrent with the involvement of other systems in every 4 cases. In 50% of cases, GIIT involved 2 organs or more; lymph nodes in 50.0%, the intestine in 45.2%, the liver in 27.8%; the peritoneum in 23.0% of cases, less frequently the stomach, pancreas, omentum, esophagus, gallbladder. The complications due to GITT were perforation of ulcers of cavitary organs in 64.6%, intestinal bleeding in 33.3%, and ileum in 12.7%. At different sites of GITT, mortality ranged from 12.5 to 85.0% and as a whole it was 58.0%. In tuberculosis of cavitary organs, the risk of death is caused by its complications in 100%, intraabdominal and retroabdominal lymph nodes in a third of cases; in hepatic tuberculosis, the risk of hepatocellular insufficiency was equal to 0.2.
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