A patient with Crohn's disease may develop different types of fistulas. Rarely these may extend across the diaphragm.
Patient selection: Crohn's disease
Intrathoracic fistulas may include:
(1) colobronchial (often between colon at the splenic flexure and the bronchus to the left lower lobe)
(2) colopleural
(3) colopericardial
Manifestations:
(1) fecopneumothorax, with fecal material draining from a chest tube
(2) fecal contents in sputum
(3) recurrent pneumonia
(4) sepsis
The diagnosis can be confirmed by imaging studies demonstrating the fistula tract.
Differential diagnosis:
(1) amebiasis
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Specialty: Gastroenterology
