Changes in pulmonary tissue because of esophageal achalasia. clinical case
DOI:
https://doi.org/10.15587/2313-8416.2015.38158Keywords:
esophageal achalasia, pulmonary tuberculosis, clinical case, treatment of tuberculosis, aspiration pneumoniaAbstract
Esophageal achalasia is a disease of unknown etiology, accompanied by the motility disorder, which leads to the esophageal food impaction. According to statistics, the incidence of esophageal achalasia is only 1 case per 100 000 population. Despite the fact that the disease is quite rare, physician-pulmonologist still meets such patients in the practice. At night, aggressive gastric contents in patients with esophageal achalasia can enter the respiratory tract, causing mostly aspiration pneumonia, less often - pulmonary tuberculosis. Features of treatment of pulmonary tuberculosis with esophageal achalasia are under-investigated, the problem is urgent.
Objective: to analyze the characteristics of pulmonary tuberculosis in patients with esophageal achalasia, to optimize the treatment regimens for such patients.
Methods: from 2008 to 2012, we observed 4 cases of esophageal achalasia patients with pulmonary disease as a complication. All patients had recurrent pneumonia. One patient with a history of frequent pneumonia had pulmonary tuberculosis.
Result: treatment of pulmonary tuberculosis with concomitant esophageal achalasia is difficult in some cases because of the food impaction in the gastrointestinal tract. As a result, a standard regimen of tuberculosis treatment by oral drugs may be ineffective, and parenteral or intramuscular administration of antituberculosis drugs is recommended in this case.
Conclusion: injection of anti-TB drugs is mainly recommended for pulmonary tuberculosis patients with concomitant esophageal achalasia
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