|
KMID : 0812020090150020135
|
|
Korean Journal of Neurogastroenterology and Motility
2009 Volume.15 No. 2 p.135 ~ p.140
|
|
|
Achalasia in a Patient with Disseminated Tuberculosis
|
|
Hwang Tae-Jun
Kim Na-Young
Kim So-Yeon
Kim Hyung-Ho
Lee Byoung-Hwan
Nam Ryoung-Hee
Lee Hee-Eun
Lee Dong-Ho
|
|
|
Abstract
|
|
|
|
Achalasia is a well-known esophageal motility disorder characterized by absent primary peristalsis and incomplete relaxation of the lower esophageal sphincter. Idiopathic achalasia is common and could result from infections, intestinal pseudo-obstruction, amyloidosis, surgery, systemic disorders or malignancies. However, achalasia related to Mycobacterium tuberculosis infection has never been reported. We present a case of a 79-year-old woman with achalasia and disseminated tuberculosis initially complaining severe dysphagia and weight reduction of 10 kg over two years. The findings of esophageal manometry and esophagogram were consistent with achalasia. computed tomography (CT) of the abdomen and chest showed a dilated esophagus and multiple nodules in the liver and the spleen as well as lymphadenitis. The result of nested TB PCR of the hepatic nodules was positive. After starting treatment for the tuberculosis, the dysphagia was much improved, suggesting a relation between achalasia and tuberculosis. In addition, the multiple nodules in the liver and spleen with the lymphadenitis on CT improved by the tuberculosis treatment. As the dysphagia of the patient was persistent, laparoscopic myotomy was performed; which was followed by only a small improvement of the dysphagia postsurgically. Dysphagia subsided gradually over 10 months along anti-tuberculosis treatment. In conclusion, this case suggests a possible association between achalasia and M. tuberculosis infection although there was no direct evidence.
|
|
|
KEYWORD
|
|
|
Achalasia, Mycobacterium Tuberculosis, Laparoscopic myotomy
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
  
|