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克罗恩病患者出现持续性肺炎伴支气管肺瘘:一例报告

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

作者信息

Alameel Turki, Maclean D Alex, Macdougall Ryan

机构信息

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

出版信息

Cases J. 2009 Nov 30;2:9114. doi: 10.1186/1757-1626-2-9114.

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.

摘要

结肠支气管瘘是克罗恩病的一种罕见并发症。首次就诊时也很少被诊断出来。我们描述了一例患有克罗恩病的患者出现结肠支气管瘘和复发性肺炎的病例。一名有克罗恩病病史的52岁男性患者出现左肺下叶空洞性肺炎,尽管接受了为期一个月的抗生素治疗,但病情并未好转。胸部计算机断层扫描证实左肺下叶存在空洞性肺炎。随后的腹部计算机断层扫描显示脾曲结肠与左支气管间隙之间存在瘘管相通。患者接受了手术,从脾曲到左肺可见一条纤维束。继续进行了为期六周的抗生素治疗,患者术后12周情况良好。很少有结肠支气管瘘的病例报告,其临床表现与本病例相似。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b0ab/2803911/bb11fde51f4e/1757-1626-2-9114-1.jpg

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