Role Of Clinical,Endoscopy,Pathology,Radiology Features And Blood Parameters In Diagnosing Esophageal Tuberculosis

Background Esophageal Tuberculosis is etiologically cause by Mycobacterium Tuberculosis involvement of the esophagus and it is rare.Great challenges of diagnosis is due to no specific accuracy of diagnostic tool in isolating tubercle bacilli,few literature reviews of published clinical trials as well it can mimicking other diseases such as malignancies and crohn's disease.ObjectiveTo evaluate the role of clinical,endoscopy,pathology,radiology features and blood parameters in diagnosing esophageal tuberculosis.MethodWe analyzed retrospectively patients with esophageal ulcer by Endoscopy from January 2012 to December 2018 and obtained patients with definitive diagnosis of Esophageal Tuberculosis.Patient's demographic information,clinical,endoscopy,pathology,radiology,blood parameters and treatment outcome were reviewed.Statistical analysis was performed with SPSS version 26 as differences in variables were evaluated with student-t test for comparing blood parameters with a p-value<0.05.ResultA total of 2084 patients esophageal ulcer whereby 10 patients with definitive Esophageal tuberculosis.Their median age was 61 yrs old(range38-77 yrs old)of whom 7(70%)were male and 5(50%)known type ARh.Most patients were 6(60%)smokers and alcoholic drinkers and 4(40%)patients were mostly Diabetic type 2 and 4(40%)hypertension followed by two patients with known esophageal carcinoma with one patients diagnosed with Myasthenia.Gravis.All 9(90%)were seronegative for HIV AIDS.Most presenting clinical features were retrosternal pain 4(40%)and 3(30%)were with dysphagia and mostly 9(90%)symptoms were presented more than 8 weeks.Moreover 5(50%)were ulcer as common lesions and 9(90%)located on the mid-esophagus with one-two patients with pseudodiverticulum.Caseating mediastinal lymphadenopathy were commonly presents in CT as well epithelioid granuloma presents in pathological examinations.ESR and CRP were significant findings over WBC and RBC in determine the effect of antitubercular medicine taken.ATT were taken and all patients recovered.There were 4 patients with differential diagnosis of crohn's disease followed by two with diagnosed esophageal carcinoma.Conclusion With sparsity of literature pertaining to Esophageal tuberculosis as well with no specific accurate diagnostic tool in diagnosing Esophageal Tuberculosis a diligent assessment of patient's demographic information,clinical,endoscopic,pathologic and radiologic features with blood parameters could aid in early diagnosis and preventing complications arise as well unnecessary surgery.Esophageal Tuberculosis can be successfully treated with sequela antitubercular therapy.