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Case Reports
. 2018 Aug 20:2018:bcr2018224408.
doi: 10.1136/bcr-2018-224408.

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

Karim El-Hag  1 , Pietro Renzulli  2 , Daniel Franzen  3 , Malcolm Kohler  3
Affiliations
Case Reports

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

Karim El-Hag et al. BMJ Case Rep. .

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.

Keywords: crohn’s disease; pneumonia (respiratory medicine).

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Conflict of interest statement

Competing interests: None declared.

Figures

Figure 1
Figure 1
(A) Posteroanterior and (B) lateral chest radiograph on admission showing confluent consolidations in the left lower lobe.
Figure 2
Figure 2
Axial low-dose CT demonstrating a persisting left lower lobe consolidation.
Figure 3
Figure 3
(A-D) Axial low-dose CT depicting the colobronchial fistula by retrograde contrast injection through the percutaneous pigtail catheter (→).
See this image and copyright information in PMC

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