Dysphagia due to tuberculosis

Objective: Dysphagia due to tuberculosis is rare in both the developing countries with high prevalence rates and the western population following the recent upsurge linked to the AIDS and immigration. Aim: To study tuberculosis as an aetiological factor in the causation of dysphagia and to evaluate the outcome of anti-tubercular treatment and surgical results in these patients. Methods: Retrospective review of experience with 14 cases of dysphagia due to tuberculosis encountered between 1996 and 2003. Results: The duration of symptoms ranged between 3 and 18 months. All of them underwent oesophagogastroscopy, barium swallow, fiberoptic bronchoscopy and CT scan of the chest. The aetiology was subcarinal node enlargement in seven, tracheo-oesophageal fistula in four, oesophageal ulcer in two and cervical node suppuration in one. Tuberculous involvement was confirmed by pathological examination in all patients. All of them received anti-tuberculous therapy. Seven patients required surgery, transthoracic repair of tracheo-oesophageal fistula in four patients, one patient required subcarinal node excision and two needed abscess drainage. There were no mortalities and there was complete relief of dysphagia in all of them. Conclusions: Tuberculosis as a causative factor for dysphagia should be considered in regions with high incidences of tuberculosis and in immunocompromised patients. Treatment with anti-tuberculous therapy is effective. Surgery is required only for complications of tuberculosis.