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Goussard P, Eber E, Venkatakrishna S, Frigati L, Janson J, Schubert P, Andronikou S. Complicated intrathoracic tuberculosis: Role of therapeutic interventional bronchoscopy. Paediatr Respir Rev 2023; 45:30-44. [PMID: 36635200 DOI: 10.1016/j.prrv.2022.12.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2022] [Accepted: 12/14/2022] [Indexed: 12/23/2022]
Abstract
In recent years bronchoscopy equipment has been improved with smaller instruments and larger size working channels. This has ensured that bronchoscopy offers both therapeutic and interventional options. As the experience of paediatric interventional pulmonologists continues to grow, more interventions are being performed. There is a scarcity of published evidence in the field of interventional bronchoscopy in paediatrics. This is even more relevant for complicated pulmonary tuberculosis (PTB). Therapeutic interventional bronchoscopy procedures can be used in the management of complicated tuberculosis, including for endoscopic enucleations, closure of fistulas, dilatations of bronchial stenosis and severe haemoptysis. Endoscopic therapeutic procedures in children with complicated TB may prevent thoracotomy. If done carefully these interventional procedures have a low complication rate.
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Affiliation(s)
- Pierre Goussard
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa.
| | - Ernst Eber
- Division of Paediatric Pulmonology and Allergology, Department of Paediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria
| | - Shyam Venkatakrishna
- Department of Pediatric Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Lisa Frigati
- Department of Paediatrics and Child Health, Faculty of Medicine and Health Sciences, Stellenbosch University, Tygerberg Hospital, Cape Town, South Africa
| | - Jacques Janson
- Department of Surgical Sciences, Division of Cardiothoracic Surgery, Stellenbosch University, and Tygerberg Hospital, Tygerberg, South Africa
| | - Pawel Schubert
- Division of Anatomical Pathology, Tygerberg Hospital, National Health Laboratory Service, Faculty of Medicine and Health Sciences, Stellenbosch University, Cape Town, South Africa
| | - Savvas Andronikou
- Department of Pediatric Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA; Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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2
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Khan A, Chakravarty A, Naqishbandi R, Qamar S. Atypical presentation of acquired tracheo-oesophageal fistula in an adolescent girl with pulmonary tuberculosis. BMJ Case Rep 2022; 15:15/2/e242384. [PMID: 35228211 PMCID: PMC8886356 DOI: 10.1136/bcr-2021-242384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
We report a case of an adolescent girl presenting with acute respiratory distress syndrome (ARDS) requiring mechanical ventilation. Initial presentation during the ongoing COVID-19 pandemic was compatible with multisystem inflammatory response in children associated with COVID-19 (MIS-C). Subsequently a diagnosis of tuberculosis was made. During ventilation, she developed significant abdominal distension which was not relieved with nasogastric decompression. There was a high index of suspicion of bronchoenteric fistula. Bronchoscopy with adjunct oesophagoscopy demonstrated tracheo-oesophageal fistula (TEF). The classical presentation of TEF has been masked by onset of ARDS. During the pandemic the diagnosis of tuberculosis in high-burden countries decreased for multiple reasons leading to development of complications which are often confused with MIS-C. While diagnosing MIS-C, maintaining a high level of suspicion for concomitant or alternative aetiologies is essential.
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Affiliation(s)
- Afreen Khan
- Pediatrics, Hamdard Institute of Medical Science and Research, Delhi, Delhi, India
| | - Aparna Chakravarty
- Pediatrics, Hamdard Institute of Medical Science and Research, Delhi, Delhi, India
| | - Rizwan Naqishbandi
- Pediatrics, Hamdard Institute of Medical Science and Research, Delhi, Delhi, India
| | - Sumbul Qamar
- Pediatrics, Hamdard Institute of Medical Science and Research, Delhi, Delhi, India
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3
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Varona Porres D, Persiva O, Sánchez AL, Cabanzo L, Pallisa E, Andreu J. Finding the bubble: atypical and unusual extrapulmonary air in the chest. RADIOLOGIA 2021; 63:358-369. [PMID: 34246426 DOI: 10.1016/j.rxeng.2021.02.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2020] [Accepted: 02/03/2021] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To describe the radiologic findings of extrapulmonary air in the chest and to review atypical and unusual causes of extrapulmonary air, emphasizing the importance of the diagnosis in managing these patients. CONCLUSION In this article, we review a series of cases collected at our center that manifest with extrapulmonary air in the thorax, paying special attention to atypical and uncommon causes. We discuss the causes of extrapulmonary according to its location: mediastinum (spontaneous pneumomediastinum with pneumorrhachis, tracheal rupture, dehiscence of the bronchial anastomosis after lung transplantation, intramucosal esophageal dissection, Boerhaave syndrome, tracheoesophageal fistula in patients with esophageal tumors, bronchial perforation and esophagorespiratory fistula due to lymph-node rupture, and acute mediastinitis), pericardium (pneumopericardium in patients with lung tumors), cardiovascular (venous air embolism), pleura (bronchopleural fistulas, spontaneous pneumothorax in patients with malignant pleural mesotheliomas and primary lung tumors, and bilateral pneumothorax after unilateral lung biopsy), and thoracic wall (infections, transdiaphragmatic intercostal hernia, and subcutaneous emphysema after lung biopsy).
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Affiliation(s)
- D Varona Porres
- Servicio de Radiodiagnóstico, Hospital Vall de Hebron, Barcelona, Spain.
| | - O Persiva
- Servicio de Radiodiagnóstico, Hospital Vall de Hebron, Barcelona, Spain
| | - A L Sánchez
- Servicio de Radiodiagnóstico, Hospital Vall de Hebron, Barcelona, Spain
| | - L Cabanzo
- Servicio de Radiodiagnóstico, Hospital Vall de Hebron, Barcelona, Spain
| | - E Pallisa
- Servicio de Radiodiagnóstico, Hospital Vall de Hebron, Barcelona, Spain
| | - J Andreu
- Servicio de Radiodiagnóstico, Hospital Vall de Hebron, Barcelona, Spain
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4
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Varona Porres D, Persiva O, Sánchez A, Cabanzo L, Pallisa E, Andreu J. Buscando la burbuja: aire torácico extrapulmonar atípico e inusual. RADIOLOGIA 2021. [DOI: 10.1016/j.rx.2021.02.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Goussard P, Andronikou S, Morrison J, van Wyk L, Mfingwana L, Janson JT. Management of children with tuberculous broncho-esophageal fistulae. Pediatr Pulmonol 2020; 55:1681-1689. [PMID: 32275811 DOI: 10.1002/ppul.24775] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 03/31/2020] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Broncho-esophageal fistula (BOF) is a rare complication of Mycobacterium tuberculosis (MTB). TB-associated BOF presents either as acute respiratory failure, aspiration pneumonia or as a complication of surgical decompression of thoracic lymph nodes. METHODS All children with TB- associated BOF were included. TB was diagnosed if MTB was cultured from respiratory secretions, Ziehl-Neelsen (ZN) smear was positive, GeneXpert MTB/RIF was positive or a chest radiograph revealed radiographic features typical of TB. BOF was diagnosed by a contrast swallow study and/or flexible bronchoscopy. Chest computed tomography (CT) scan was performed, if required. RESULTS Total of 20 children were diagnosed with TB-associated BOF between 1999 and 2019, with a 75% survival. A total of 85% BOF involved the left main bronchus. A total of 80% of patients were MTB culture or ZN smear-positive. Chest X-ray abnormalities included: extensive parenchymal disease (80%) and lymph gland enlargement (45%). CT features included visualization of the BOF (60%), esophageal air (73%) and pneumomediastinum (40%). BOF closure was achieved by surgical closure (46%), spontaneous closure (26%), fibrin glue (13%), and esophageal stent (13%). Multivariant regression analysis showed that C- reactive protein (CRP), albumin and CRP/albumin ratio were associated with mortality. CONCLUSION Most TB-associated BOF are left-sided. It presents either acutely, with respiratory failure, or with chronic respiratory symptoms of aspiration. Children requiring invasive ventilation have high mortality. Most TB-associated BOF requires surgical intervention, although the use of fibrin glue offers an attractive alternative option.
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Affiliation(s)
- Pierre Goussard
- Department of Paediatrics and Child Health, Tygerberg Hospital, Stellenbosch University, Tygerberg, South Africa
| | - Savvas Andronikou
- Department of Pediatric Radiology, The Children's Hospital of Philadelphia, University of Pennsylvania
| | - Julie Morrison
- Department of Paediatrics and Child Health, Tygerberg Hospital, Stellenbosch University, Tygerberg, South Africa
| | - Lizelle van Wyk
- Department of Paediatrics and Child Health, Tygerberg Hospital, Stellenbosch University, Tygerberg, South Africa
| | - Lunga Mfingwana
- Department of Paediatrics and Child Health, Tygerberg Hospital, Stellenbosch University, Tygerberg, South Africa
| | - Jacques T Janson
- Department of Cardio-Thoracic Surgery, Tygerberg Hospital, Stellenbosch University, Tygerberg, South Africa
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Rana K, Bhargava EK, Batra V, Arora N, Meher R. Tuberculous Bronchoesophageal Fistula in Nephrotic Syndrome: A Silent Assassin. Indian J Otolaryngol Head Neck Surg 2019; 71:104-106. [PMID: 31741942 DOI: 10.1007/s12070-017-1130-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2015] [Accepted: 04/05/2017] [Indexed: 10/19/2022] Open
Abstract
Tuberculosis, a global public health concern, is emerging as an important complication in children with nephrotic syndrome. We report a case of an adolescent with nephrotic syndrome who developed fatal miliary tuberculosis after initiation of steroid therapy, presenting as a bronchoesophageal fistula. The case highlights the importance of maintaining a high index of suspicion prior to starting immunosuppressive therapy in pediatric patients of nephrotic syndrome.
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Affiliation(s)
- Kanika Rana
- Department of Otorhinolaryngology - Head and Neck Surgery, Maulana Azad Medical College and Associated Loknayak, G.N.E.C. and G.B. Pant Hospitals, New Delhi, India
| | - Eishaan Kamta Bhargava
- Department of Otorhinolaryngology - Head and Neck Surgery, Maulana Azad Medical College and Associated Loknayak, G.N.E.C. and G.B. Pant Hospitals, New Delhi, India
| | - Vasun Batra
- Department of Otorhinolaryngology - Head and Neck Surgery, Maulana Azad Medical College and Associated Loknayak, G.N.E.C. and G.B. Pant Hospitals, New Delhi, India
| | - Nikhil Arora
- Department of Otorhinolaryngology - Head and Neck Surgery, Maulana Azad Medical College and Associated Loknayak, G.N.E.C. and G.B. Pant Hospitals, New Delhi, India
| | - Ravi Meher
- Department of Otorhinolaryngology - Head and Neck Surgery, Maulana Azad Medical College and Associated Loknayak, G.N.E.C. and G.B. Pant Hospitals, New Delhi, India
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7
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Treatment of a broncho-esophageal fistula complicated by severe ARDS. Infection 2018; 47:483-487. [PMID: 30417214 DOI: 10.1007/s15010-018-1247-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 11/02/2018] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Broncho-esophageal fistula formation is a rare complication of tuberculosis, most often seen in immunocompromised patients. METHODS AND RESULTS In this paper, we report the case of a young non-immunocompromised refugee from Somalia diagnosed with open pulmonary tuberculosis complicated by extensive osseous involvement and a broncho-esophageal fistula with consecutive aspiration of gastric contents. The patient rapidly developed a severe acute respiratory distress syndrome (ARDS) requiring venovenous extracorporeal membrane oxygenation (ECMO) therapy for nearly 2 months. The fistula was initially treated by standard antituberculous combination therapy and implantation of an esophageal and a bronchial stent. Long-term antibiotic treatment was instituted for pneumonia and mediastinitis. 7 months later, discontinuity resection of the esophagus was performed and the bronchial fistula covered by an intercostal muscle flap. DISCUSSION This case illustrates that tuberculosis should always be suspected in patients from high-incidence countries in case of lung involvement and that an interdisciplinary approach including long-term intensive care management can enable successful treatment of tuberculosis with severe, near-fatal complications.
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An unusual cause of haemoptysis in childhood: A case report and literature review. Afr J Thorac Crit Care Med 2018; 24. [PMID: 34541508 PMCID: PMC8424777 DOI: 10.7196/sarj.2018.v24i3.191] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/09/2018] [Indexed: 11/08/2022] Open
Abstract
Haemoptysis is uncommon in children and the diagnosis is challenging. We describe a 14-year-old child who presented with haemoptysis secondary to a suspected congenital broncho-oesophageal fistula. This is a rare condition and the symptoms are insidious, occasionally beginning in childhood but may present only in adulthood. The case report describes the presentation, diagnosis and management of broncho-oesophageal fistulas, with a review of the current literature.
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9
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Hegde RG, Kalekar TM, Gajbhiye MI, Bandgar AS, Pawar SS, Khadse GJ. Esophagobronchial fistulae: Diagnosis by MDCT with oral contrast swallow examination of a benign and a malignant cause. Indian J Radiol Imaging 2013; 23:168-72. [PMID: 24082484 PMCID: PMC3777329 DOI: 10.4103/0971-3026.116562] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
We report two cases of esophagobronchial fistulae diagnosed by Multi-detector computed tomography (MDCT) oral contrast swallow examination. It is helpful to supplement the CT study with an oral contrast swallow as it aids in confirmation of a suspected fistula and also demonstrates the fistula tract better. We present the clinical details and the imaging findings on MDCT of two cases of esophagobronchial fistulae – one secondary to chronic chest tuberculosis and the other secondary to a squamous cell carcinoma of the upper esophagus – followed by discussion of the etiology, pathogenesis, and imaging of these fistulae.
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Affiliation(s)
- Rahul G Hegde
- Department of Radiology, Byramjee Jeejeebhoy Medical College and Sassoon General Hospital, Pune, India
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10
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Chan AC, Leung JS, Lee AK, Li R, Tam C, Leung C, Law W. An unusual case of double tuberculous broncho‐oesophageal fistulas in an adult. Respirology 2008. [DOI: 10.1111/j.1440-1843.2000.00283.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Alan Chi‐Kuen Chan
- Tuberculosis and Chest Service, Department of Health, Hong Kong, Departments of
| | | | | | - Robert Li
- Radiology, St Paul Hospital, Hong Kong
| | - Cheuk‐Ming Tam
- Tuberculosis and Chest Service, Department of Health, Hong Kong, Departments of
| | - Chi‐Chiu Leung
- Tuberculosis and Chest Service, Department of Health, Hong Kong, Departments of
| | - Wing‐Sze Law
- Tuberculosis and Chest Service, Department of Health, Hong Kong, Departments of
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11
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Erlank A, Goussard P, Andronikou S, Gie R, Sidler D, Ackermann C, Parsons J, Greyling J. Oesophageal perforation as a complication of primary pulmonary tuberculous lymphadenopathy in children. Pediatr Radiol 2007; 37:636-9. [PMID: 17525846 DOI: 10.1007/s00247-007-0482-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2006] [Revised: 03/11/2007] [Accepted: 03/25/2007] [Indexed: 10/23/2022]
Abstract
BACKGROUND Involvement of the oesophagus by tuberculosis is rare, and erosion and perforation of the oesophagus by tuberculous lymphadenopathy is an unusual complication of primary pulmonary tuberculosis. There are very few reports describing both CT and contrast swallow appearances of these lesions. OBJECTIVE To describe the CT and contrast swallow appearances of oesophageal erosion and perforation by lymphadenopathy as a complication of primary pulmonary tuberculosis in children. MATERIALS AND METHODS Imaging of three children with confirmed pulmonary tuberculosis and oesophageal perforation was retrospectively reviewed. RESULTS Tuberculosis was confirmed by culture in all three patients. Contrast swallow demonstrated a contained leak in two patients and a tracheo-oesophageal fistula in one. Two patients had mediastinal air and one patient had a mediastinal collection on CT. All patients had features diagnostic of pulmonary tuberculosis on CT. CONCLUSION The imaging features comprise leakage of contrast medium with or without fistula formation on contrast swallow, large low-density lymph nodes on CT, and mediastinal air. The use of retrievable stents is a promising idea in this condition.
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Affiliation(s)
- Anita Erlank
- Department of Radiology, Stellenbosch University Medical School, P.O. Box 19063, Tygerberg 7505, South Africa
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12
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Park KS, Lee SY, Min SG, Park JC, Son YP. The Tuberculous Bronchoesophageal Fistula Detected during Induction of General Anesthesia in Brain Abscess Patient -A case report -. Korean J Anesthesiol 2007. [DOI: 10.4097/kjae.2007.53.5.645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Kwan Sik Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, Ajou University, Suwon, Korea
| | - Sook Young Lee
- Department of Anesthesiology and Pain Medicine, College of Medicine, Ajou University, Suwon, Korea
| | - Sang Gee Min
- Department of Anesthesiology and Pain Medicine, College of Medicine, Ajou University, Suwon, Korea
| | - Jong Cook Park
- Department of Anesthesiology and Pain Medicine, College of Medicine, Cheju National University, Jeju, Korea
| | - Young Pyo Son
- Department of Anesthesiology and Pain Medicine, College of Medicine, Ajou University, Suwon, Korea
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13
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Park EH, Jang TW, Park MI, Song JY, Choi IS, Oak CH, Jung MH, Kwon JH. A Case of Esophago-mediatinal Fistula Due to Esophageal Tuberculosis. Tuberc Respir Dis (Seoul) 2007. [DOI: 10.4046/trd.2007.62.6.531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Eun Ho Park
- Department of Internal Medicine, College of Medicine, Kosin University, Pusan, Korea
| | - Tae Won Jang
- Department of Internal Medicine, College of Medicine, Kosin University, Pusan, Korea
| | - Mu In Park
- Department of Internal Medicine, College of Medicine, Kosin University, Pusan, Korea
| | - Jun Young Song
- Department of Internal Medicine, College of Medicine, Kosin University, Pusan, Korea
| | - In Su Choi
- Department of Internal Medicine, College of Medicine, Kosin University, Pusan, Korea
| | - Chul Ho Oak
- Department of Internal Medicine, College of Medicine, Kosin University, Pusan, Korea
| | - Maan Hong Jung
- Department of Internal Medicine, College of Medicine, Kosin University, Pusan, Korea
| | - Jin Hwan Kwon
- Department of Radiology, College of Medicine, Kosin University, Pusan, Korea
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14
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Goussard P, Sidler D, Kling S, Andronikou S, Rossouw GF, Gie RP. Esophageal stent improves ventilation in a child with a broncho-esophageal fistula caused by Mycobacterium tuberculosis. Pediatr Pulmonol 2007; 42:93-7. [PMID: 17133521 DOI: 10.1002/ppul.20532] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
The deployment of an esophageal stent to aid in the ventilation of a child who had developed an acquired broncho-esophageal fistula caused by Mycobacterium tuberculosis (MTB) is described. The 12-month-old boy presented with respiratory failure requiring ventilation. The air leak via the fistula led to inadequate mechanical ventilation. The deployment of the stent resulted in successful ventilation, closure of the fistula, and eventual successful treatment.
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Affiliation(s)
- P Goussard
- Department of Pediatrics and Child Health, University of Stellenbosch and Tygerberg Children's Hospital, Cape Town, South Africa.
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15
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Tomiyama K, Ishida H, Miyake M, Taki T. Benign acquired bronchoesophageal fistula in an adult. Gen Thorac Cardiovasc Surg 2003; 51:242-5. [PMID: 12831238 DOI: 10.1007/s11748-003-0021-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
A 45-year-old woman was admitted to our hospital with a diagnosis of bronchoesophageal fistula, after a barium esophagography performed in an annual medical check-up had demonstrated an esophageal diverticulum in the middle of the thoracic esophagus, having a narrow bridge between the right intermediate bronchi. The patient had a history of tuberculosis in her childhood, and chest radiography showed multiple calcified hilar lymph nodes. The fistula was observed on gastroenteroscopy and on bronchofiberscopy. The patient was treated surgically, with ligation and resection of the fistula. The fistulous tract was attached to a calcified hilar lymph node, and both the diverticulum and fistula were concluded to have been caused by the tuberculous lymphadenitis in her childhood. It is very uncommon to have bronchoesophageal fistula, caused by tuberculosis in childhood, diagnosed and treated surgically at more than forty years later.
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Affiliation(s)
- Kenichi Tomiyama
- Department of Thoracic Surgery, Kitano Hospital, Tazuke Kofukai Medical Research Institute, Osaka, Japan
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16
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Abstract
We report two cases of gastric tuberculosis (TB) in Nigerians. The first case concerns an elderly man initially thought to have abdominal malignancy but was subsequently found to have extensive and complicated gastric TB coexisting with chronic peptic ulcer disease. The second case involved the extremely rare condition of gastro-bronchial fistula in a young woman. In contrast to previously reported cases, it was of tuberculous origin and pulmonary symptoms were minimal. Both cases were radiologically evident.
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Affiliation(s)
- E O Okoro
- Department of Medicine, University of Ilorin Teaching Hospital, Nigeria
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17
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Affiliation(s)
- R P Gie
- Department of Paediatrics and Child Health, Faculty of Medicine, University of Stellenbosch, Tygerberg, South Africa
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18
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Castaner E, Gallardo X, Mata JM. Common and uncommon complications of reactivation tuberculosis in immunocompetent patients. Eur J Radiol 1998; 27:43-52. [PMID: 9587767 DOI: 10.1016/s0720-048x(97)00151-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Affiliation(s)
- E Castaner
- SDI-UDIAT Consorci Hospitalari, Parc Tauli, Sabadell, Spain
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19
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Abstract
Esophagocutaneous fistula due to tuberculosis is a distinctly rare entity, with only two cases reported over the past 25 years. We report this unusual complication in an 85-year-old, human immunodeficiency virus-negative man and review the relevant literature.
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Affiliation(s)
- S Xavier
- Department of Gastroenterology Postgraduate Institute of Medical Education and Research, Chandigarh, India
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20
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Abstract
Bronchoesophageal fistulas (BEF) are uncommon in children, the etiology being congenital or acquired. Acquired bronchial perforation of tuberculous origin is common in children with pulmonary tuberculosis but bronchoesophageal perforation secondary to tuberculosis and leading to a fistulous tract formation is rare. To date, there have only been 4 case reports of BEF of tuberculous origin in children. We present yet another case of an acquired BEF of tuberculous origin in a child who presented with a sudden onset of dysphagia and choking sensation.
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Affiliation(s)
- R Bhatia
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi
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21
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Abstract
Tuberculosis of the esophagus is rare. More cases of secondary tuberculosis of the esophagus have been reported compared to primary esophageal tuberculosis. An illustrative case of primary tuberculosis of the esophagus is presented and 54 published cases of esophageal involvement in tuberculosis are reviewed. There were eight primary and 46 secondary cases of esophageal tuberculosis. There were more male than female patients (M/F = 2.6:1) with an average age of 39.2 years (range 6 months to 75 years). Diagnosis can be difficult, being based on clinical, radiological, endoscopic, and histological features and on the response to chemotherapy. Most cases can be successfully treated with antituberculous chemotherapy even in the presence of fistulous tracts. Patients with esophageal tuberculosis in the presence of AIDS do not respond as well to antituberculous chemotherapy.
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Affiliation(s)
- J Eng
- Department of Thoracic Surgery, Bradford Royal Infirmary, England
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22
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Ramakantan R, Shah P. Tuberculous fistulas of the pharynx and esophagus. GASTROINTESTINAL RADIOLOGY 1990; 15:145-7. [PMID: 2318385 DOI: 10.1007/bf01888759] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Four patients with tuberculous fistulas communicating with the pharynx or the esophagus are reported. In 1 patient, there was strong evidence to suggest primary involvement of the esophageal mucosa. The other 3 cases were related to involvement of the pharynx or the esophagus from adjacent tuberculous process, as confirmed by histopathological proof. The patients had varying degrees of symptoms, which in two dramatically responded to antituberculous therapy; the third patient needed surgery for complete cure and the last patient was lost to follow-up.
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Affiliation(s)
- R Ramakantan
- Department of Radiology, King Edward Memorial Hospital, Bombay, India
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Affiliation(s)
- P M Stoopack
- Department of Medicine, Kings County Hospital, New York
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24
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Sang K, Newman B, Bowen AD, Bender TM. Pediatric airway disorders: practical approaches to imaging evaluation. Curr Probl Diagn Radiol 1989; 18:193-233. [PMID: 2676359 DOI: 10.1016/0363-0188(89)90012-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Affiliation(s)
- K Sang
- Department of Radiology, Children's Hospital of Pittsburgh, University of Pittsburgh School of Medicine, Pennsylvania
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Cameron DC. Non-malignant oesophago-bronchial fistulae in the adult. Case reports and review of the literature. AUSTRALASIAN RADIOLOGY 1983; 27:143-53. [PMID: 6639540 DOI: 10.1111/j.1440-1673.1983.tb02423.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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