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Open Access Case Report

Colobronchial fistula presenting with persistent pneumonia in a patient with Crohn's disease: a case report

Turki AlAmeel1*, D Alex MacLean2 and Ryan MacDougall3

Author Affiliations

1 Division of Gastroenterology, The University of Western Ontario, London, ON, Canada

2 Department of Medicine, Dalhousie University, Halifax, Nova Scotia, Canada

3 Department of Radiology, Dalhousie University, Halifax, Nova Scotia, Canada

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Cases Journal 2009, 2:9114  doi:10.1186/1757-1626-2-9114

Published: 30 November 2009

Abstract

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.