ABSTRACT
An 80 year-old man had symptomatic diffuse esophageal spasms for a few months. They were documented by radiographic, endoscopic and manometric findings. The post-mortem neuropathological examination showed a granular ependymitis of the fourth ventricle involving the dorsal region of the motor dorsal nuclei of the vagus nerve which showed frank neuronal loss. The muscular wall of the esophagus, its myenteric plexus and the fasciculi of the vagus nerve were histologically normal. This is the first published case of such a brainstem lesion associated with symptomatic diffuse esophageal spasms. These pathological data are compared with those already published on achalasia.
Subject(s)
Brain Stem/pathology , Encephalitis/complications , Ependyma , Esophageal Diseases/etiology , Aged , Encephalitis/pathology , Ependyma/pathology , Esophageal Diseases/pathology , Humans , Male , Spasm/etiology , Vagus Nerve/pathologyABSTRACT
The authors report the case of a 26 year old man who presented with jaundice after an operation for peritoneal and ileal tuberculosis. Abdominal sonography, CT Scan and endoscopic retrograde cholangio-pancreatography showed that the jaundice was due to the compression of the common bile duct by tuberculous lymph nodes. This compression disappeared after spontaneous fistulisation into the common bile duct. The review of the literature shows that this localisation of tuberculous lymphadenitis is uncommon and is rarely diagnosed before laparotomy. Antituberculous therapy alone is generally not sufficient and should be associated with surgical treatment.
