Colobronchial fistula: a rare cause of non-resolving pneumonia in Crohn’s disease

Abstract

We discuss the case of a 44-year-old man with a refractory left lower lobe pneumonia progressing to a pulmonary abscess caused by a colobronchial fistula, a rare complication of underlying Crohn's disease. The patient presented with weight loss and signs of a pulmonary consolidation, which responded incompletely to the targeted antibiotic treatment. The causative colobronchial fistula was demonstrated by CT-guided puncture and retrograde injection of contrast medium. After fistula excision, the patient recovered rapidly with a weight gain of 4 kg within a few weeks.

Enterogenic empyema complicating colobronchial fistula: a case report

“…Both the colon and lung directly adhere to the diaphragm and the fistula forms between colon and lung through the diaphragm. It may be caused by Crohn's disease, pulmonary infection or abscess, iatrogenic intraperitoneal adhesions, colonic cancer invasion, or pulmonary tuberculosis [2][3][4][5][6]. In this case, the patient suffered from sustained hemoptysis and fever, while the infection was located in the middle lobe, which was near the diaphragm.…”