Bronchoesophageal Fistula in a Patient with Crohn's Disease Receiving Anti-TNF Therapy

We report a case of tuberculosis and BEF in a patient with CD who received anti-TNF therapy. A 33-year-old Korean woman developed fever and cough 2 months after initiation of anti-TNF therapy. And the symptoms persisted for 1 months, so she visited the emergency room. Chest computed tomography was performed upon visiting the emergency room, which showed BEF with aspiration pneumonia. Esophagogastroduodenoscopy with biopsy and endobronchial ultrasound with transbronchial needle aspiration confirmed that the cause of BEF was tuberculosis. Anti-tuberculosis medications were administered, and esophageal stent insertion through endoscopy was performed to manage the BEF. However, the patient's condition did not improve; therefore, fistulectomy with primary closure was performed. After fistulectomy, the anastomosis site healing was delayed due to severe inflammation, a second esophageal stent and gastrostomy tube were inserted. Nine months after the diagnosis, the fistula disappeared without recurrence, and the esophageal stent and gastrostomy tube were removed.PMID:34932900 | DOI:10.5946/ce.2021.215

Source: Clinical Endoscopy - December 21, 2021 Category: Gastroenterology Authors: Kyunghwan Oh Kee Don Choi Hyeong Ryul Kim Tae Sun Shim Byong Duk Ye Suk-Kyun Yang Sang Hyoung Park Source Type: research