Oesophageal perforation as a complication of primary pulmonary tuberculous lymphadenopathy in children.
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.


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.


CONCLUSIONS
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.
Erlank
Anita
A
Department of Radiology, Stellenbosch University Medical School, P.O. Box 19063, Tygerberg 7505, South Africa.
Goussard
Pierre
P
Andronikou
Savvas
S
Gie
Robert
R
Sidler
Daniel
D
Ackermann
Christelle
C
Parsons
Jaco
J
Greyling
Jaco
J
D001999:Bronchoscopy; D003287:Contrast Media; D003937:Diagnosis, Differential; D004939:Esophageal Perforation / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D017809:Fatal Outcome; D005260:Female; D006801:Humans; D007223:Infant; D015607:Stents; D014057:Tomography, X-Ray Computed; D014388:Tuberculosis, Lymph Node / Q000150:complications* / Q000175:diagnosis; D014397:Tuberculosis, Pulmonary / Q000150:complications* / Q000175:diagnosis
D003287:Contrast Media