Tuberculosis and Respiratory Diseases

The Korean Academy of Tuberculosis and Respiratory Diseases (대한결핵및호흡기학회)
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A Case of Bronchoesophageal Fistula Mimicking Pulmonary Tuberculosis

폐 결핵으로 오인된 기관지식도루 1예

  • Oh, Dong Wook (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Ra, Seung Won (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Lee, Kwang Ha (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Park, Tae Sun (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Sun Young (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Na, Soo Young (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine) ;
  • Kim, Won Dong (Division of Pulmonary and Critical Care Medicine, Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine)
  • 오동욱 (울산대학교 의과대학 서울아산병원 호흡기내과) ;
  • 나승원 (울산대학교 의과대학 서울아산병원 호흡기내과) ;
  • 이광하 (울산대학교 의과대학 서울아산병원 호흡기내과) ;
  • 박태선 (울산대학교 의과대학 서울아산병원 호흡기내과) ;
  • 김선영 (울산대학교 의과대학 서울아산병원 호흡기내과) ;
  • 나수영 (울산대학교 의과대학 서울아산병원 호흡기내과) ;
  • 김원동 (울산대학교 의과대학 서울아산병원 호흡기내과)
  • Received : 2008.02.19
  • Accepted : 2008.03.21
  • Published : 2008.04.30
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Abstract

Benign bronchoesophageal fistula is a rare disease and it may be characterized by nonspecific symptoms that can cause a delayed diagnosis. We misdiagnosed a patient with recurrent aspiration, which was due to bronchoesophageal fistula, as active pulmonary tuberculosis. The patient was 44 year old female who had suffered from chronic cough, especially during eating liquid meals, since 1982 when she had been treated for tuberculous lymphadenitis. Computed tomography showed an irregular mass with surrounding centrilobular nodules in the superior segment of the right lower lobe (RLL). She was diagnosed as having active pulmonary tuberculosis and treated with anti-tuberculosis medication, but she continued to complain of persistent cough even after anti-tuberculosis treatment. Thus, we reexamined the patient, and bronchoesophageal fistula between the esophagus and the superior segment of the RLL was finally confirmed by esophagography. After the fistula was surgically treated, the patient became asymptomatic and she then experienced good health.

성인에서 양성 원인에 의한 기관지식도루는 드물며 활동성 결핵이 원인 중 하나로 보고 되었지만 본 증례와 같이 결핵 후유증으로 장기간에 걸쳐서 발생할 수도 있고 만성 흡인과 기침 및 객혈의 원인이 될 수 있으며 활동성 폐결핵으로 오인될 수 있으므로 임상의사들의 주의가 필요하다.

Keywords

References

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