Oesophageal Tuberculosis: A Systematic Review Focusing on Clinical Management

Dysphagia. 2022 Aug;37(4):973-987. doi: 10.1007/s00455-021-10360-x. Epub 2021 Sep 4.


Oesophageal tuberculosis, an uncommon form of extrapulmonary tuberculosis, has been reported mainly as small case series and the literature is heterogeneous. A systematic review to characterize the clinical presentation, evaluation and management of oesophageal tuberculosis was performed. Electronic databases were searched with keywords: esophagus OR esophageal AND tuberculosis. We included original papers and case series (> 4 patients) with oesophageal tuberculosis. Twenty-two studies reporting 311 patients were included. Mean age in most of the studies was 31-51 years and male gender constituted 50.5% patients. Dysphagia (72.3%), odynophagia (22.4%) and chest pain (31.3%) were predominant symptoms. Mid-oesophagus was the commonest site of involvement (88%). Endoscopic findings included ulcers (59.9%), submucosal bulge (31.7%), extrinsic compression (24.8%) and pseudotumour (5.8%). On endoscopic ultrasound, presence of hypoechoic (69.5%), heteroechoic (47.6%) and matted (86.3%) mediastinal lymph nodes and oesophageal wall involvement (67.3%) were common findings. Computed tomography showed mediastinal lymphadenopathy (76.5%) and oesophageal thickening (52.1%). Diagnosis was confirmed by granuloma (72.3%) and acid fast bacilli positivity (32.5%) in mots patients. Response to antitubercular therapy was excellent; 97.7% patients recovered and 2.3% patients died. Surgery (14.5%) and oesophageal stenting (11.4%) were required infrequently. Oesophageal tuberculosis should be considered in endemic regions as a cause of dysphagia because early treatment is associated with excellent outcomes.

Keywords: Deglutition; Deglutition disorders; Dysphagia; Extrapulmonary tuberculosis; Gastrointestinal tuberculosis; Oesophagus; Tuberculosis.

Publication types

  • Systematic Review

MeSH terms

  • Adult
  • Deglutition Disorders* / complications
  • Deglutition Disorders* / therapy
  • Endosonography / adverse effects
  • Esophageal Diseases* / therapy
  • Humans
  • Male
  • Middle Aged
  • Tuberculosis* / complications
  • Tuberculosis* / drug therapy