Rickli et al describe a patient with ulcerative colitis (UC) who developed upper airway obstruction as an extraintestinal complication. The authors are from Kantonsspital St Gallen and Kantonales Spital Flawil in Switzerland.
Clinical features:
(1) The patient has a history of ulcerative colitis.
(2) The patient develops signs and symptoms associated with upper airway obstruction: hoarseness, cough, dyspnea.
(3) Examination of the upper airway shows inflammatory stenosis of the upper airway (glottis, trachea, main bronchi).
(4) Reversal of the obstruction following therapy with corticosteroids and with control of the ulcerative colitis.
(5) Exclusion of alternative diagnoses.
The flow volume loop (FVL) initially shows a marked reduction in both flow and volume. With effective therapy both increase to normal levels.
Chronic bronchitis with bronchiolitis is a more common extraintestinal manifestation of ulcerative colitis and may or may not be present in a patient with tracheal stenosis.
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