Gumbo T, Rice T W, Mawhorter S
Department of Infectious Disease, The Cleveland Clinic Foundation, Cleveland, Ohio, USA.
J Clin Gastroenterol. 2001 Apr;32(4):365-7. doi: 10.1097/00004836-200104000-00021.
We report the case of a patient with Crohn's disease and recurrent pneumonia for over 3 years before the discovery of an occult ileopulmonary fistula and review five other cases in the literature. Patients often present with chronic cough productive of feculent sputum, pleuritic chest pain, and signs of pulmonary consolidation that fail to respond completely to antibiotic therapy. Mixed enteric flora is cultured from sputum and bronchial washings in most cases. Bronchoscopy findings range from chronic bronchial inflammation to feculent material in the airways. Barium enema is often diagnostic. Surgery and Crohn's-specific therapy are key components of curative therapy.
我们报告了一例患有克罗恩病且反复发生肺炎超过3年的患者，该患者在发现隐匿性回肠-肺瘘之前的情况，并回顾了文献中的其他5例病例。患者常表现为咳出恶臭痰液的慢性咳嗽、胸膜炎性胸痛以及肺部实变体征，对抗生素治疗不能完全缓解。大多数情况下，从痰液和支气管灌洗物中培养出混合肠道菌群。支气管镜检查结果从慢性支气管炎到气道内有恶臭物质不等。钡剂灌肠通常具有诊断价值。手术和针对克罗恩病的治疗是治愈性治疗的关键组成部分。
