Isolated esophageal Crohn's is a rare condition with few reported cases; there are even much fewer documented case reports of esophagobronchial fistula complicating esophageal Crohn's. We present a case of isolated esophageal Crohn's with esophagobronchial fistula presenting with hemoptysis. Diagnostic considerations and therapeutic options are detailed. We recommend chest computerized tomography (with computerized virtualization of endoluminal data when available) as the imaging modality of choice, as well as traditional studies: barium swallow, bronchoscopy and upper gastrointestinal endoscopy, for a complete elucidation of all associated clinical entities. We conclude by making the case for entertaining a diagnosis of esophagobronchial or related fistulas in patients with Crohn's disease who present with interval development of respiratory symptoms or signs especially when these are persistent or recurrent.
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