Colobronchial fistula presenting with persistent pneumonia in a patient with Crohn's disease: a case report
Tóm tắt
Colobronchial fistula is an uncommon complication of Crohn's Disease. It is also rarely diagnosed on first presentation. We describe a case of colobronchial fistula and recurrent pneumonia in a patient with Crohn's Disease. A 52-year-old gentleman with a history of Crohn's Disease presented with cavitating left lower lobe pneumonia that did not resolve despite a one month course of antibiotics. A computed tomography of the thorax confirmed the presence of a cavitating left lower lobe pneumonia. A subsequent abdominal computed tomography revealed a fistulous communication between the colon at the splenic flexure and the left bronchial space. The patient underwent surgery and a fibrous tract was visualized from the splenic flexure to the left lung. Medical treatment was continued with a six week course of antibiotics and the patient was doing well 12 weeks after surgery. There have been few case reports of colobronchial fistula with a clinical picture similar to this case.
Tài liệu tham khảo
Tang LY, Rawsthorne P, Bernstein CN: Are perineal and luminal fistulas associated in Crohn's disease? A population-based study. Clin Gastroenterol Hepatol. 2006, 4 (9): 1130-1134. 10.1016/j.cgh.2006.06.021.
Leichtling JJ, Garlock JH: Granulomatous colitis complicated by gastrocolic, duodenocolic, and colopulmonic fistulas. Gastroenterology. 1962, 43: 151-165.
Domej W, Kullnig P, Petritsch W, Melisch B, Schaflinger E, Smolle-Jüttner FM, Schalk V, Ratschek M: Colobronchial fistula: a rare complication of Crohn's colitis. Am Rev Respir Dis. 1990, 142 (5): 1225-1227.
Flueckiger F, Kullnig P, Melzer G, Posch E: Colobronchial and gastrocolic fistulas: rare complication of Crohn's disease. Gastrointest Radiol. 1990, 15 (4): 288-290. 10.1007/BF01888799.
Singh D, Cole JC, Cali RL, Finical EJ, Proctor DD: Colobronchial fistula: an unusual complication of Crohn's disease. Am J Gastroenterol. 1994, 89 (12): 2250-2252.
Karmy-Jones R, Chagpar A, Vallieres E, Hamilton S: Colobronchial fistula due to Crohn's disease. Ann Thorac Surg. 1995, 60 (2): 446-448. 10.1016/0003-4975(95)00207-2.
Mera A, Sugimoto M, Fukuda K, Tanaka F, Imamura F, Matsuda M, Ando M, Shima K: Crohn's disease associated with colo-bronchial fistula. Intern Med. 1996, 35 (12): 957-960. 10.2169/internalmedicine.35.957.
File TM: Community-acquired pneumonia. Lancet. 2003, 362 (9400): 1991-2001. 10.1016/S0140-6736(03)15021-0.
Teruuchi S, Saku N, Ishii Y, Bando M, Ohno S, Sugiyama Y: A case of colon cancer with tension pneumothorax and empyema as a consequence of colo-pleural fistula. Nihon Kokyuki Gakkai Zasshi. 2000, 38 (11): 865-869.
Crofts TJ, Dalrymple JO, Buhrmann JR: Tuberculous bronchocolonic fistula. A case report. S Afr Med J. 1978, 54 (19): 795-796.
MacKay GC, Howells J, Poon FW: Colobronchial fistula: a late complication of childhood radiotherapy. Br J Radiol. 2006, 79 (938): 170-172. 10.1259/bjr/27258284.