Bronchoesophageal fistula in a patient with Crohn’s disease receiving anti-tumor necrosis factor therapy
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Tuberculosis is an adverse event in patients with Crohn’s disease receiving anti-tumor necrosis factor (TNF) therapy. However, tuberculosis presenting as a bronchoesophageal fistula (BEF) is rare. We report a case of tuberculosis and BEF in a patient with Crohn’s disease 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.
Abstract
Tuberculosis is an adverse event in patients with Crohn’s disease receiving anti-tumor necrosis factor (TNF) therapy. However, tuberculosis presenting as a bronchoesophageal fistula (BEF) is rare. We report a case of tuberculosis and BEF in a patient with Crohn’s disease 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.
참고문헌 (19)
- Park SH, "A 30-year trend analysis in the epidemiology of inflammatory bowel disease in the Songpa-Kangdong district of Seoul, Korea in 1986-2015", J Crohns Colitis, 13, pp.1410~1417 (2019)
- Jamilya Kaibullayeva, "Prevalence and patient awareness of inflammatory bowel disease in Kazakhstan: a cross-sectional study", Intestinal research, 18(4), pp.430~437 (2020), 대한장연구학회[DOI]
- Hsu-Heng Yen, "Epidemiological trend in inflammatory bowel disease in Taiwan from 2001 to 2015: a nationwide population-based study", Intestinal research, 17(1), pp.54~62 (2019), 대한장연구학회[DOI]
- Wilkens R, "Relevance of monitoring transmural disease activity in patients with Crohn’s disease : current status and future perspectives", Therap Adv Gastroenterol, 14, pp.17562848211006672~ (2021)
- 홍승욱, "The first step to unveil the epidemiology of inflammatory bowel disease in Central Asia", Intestinal research, 18(4), pp.345~346 (2020), 대한장연구학회[DOI]
- Dong Il Park, "Asian Organization for Crohn’s and Colitis and Asia Pacific Association of Gastroenterology consensus on tuberculosis infection in patients with inflammatory bowel disease receiving anti-tumor necrosis factor treatment. Part 1: risk assessment", Intestinal research, 16(1), pp.4~16 (2018), 대한장연구학회
- Spalding AR, "Acquired benign bronchoesophageal fistulas in the adult", Ann Thorac Surg, 28, pp.378~383 (1979)
- Balazs A, "Esophagorespiratory fistulas of tumorous origin. Non-operative management of 264 cases in a 20-year period", Eur J Cardiothorac Surg, 34, pp.1103~1107 (2008)
- Holder TM, "Esophageal atresia and tracheoesophageal fistula. A survey of its members by the surgical section of the american academy of pediatrics", Pediatrics, 34, pp.542~549 (1964)
- Desai P, "Bronchoesophageal fistula due to esophageal tuberculosis", Case Rep Infect Dis, 2019, pp.6537437~ (2019)
- Aissaoui H, "SARS-CoV-2 and mycobacterium tuberculosis coinfection : a case of unusual bronchoesophageal fistula", J Clin Tuberc Other Mycobact Dis, 24, pp.100247~ (2021)
- Clarke BW, "Crohn’s disease of the esophagus with esophagobronchial fistula formation : a case report and review of the literature", Gastrointest Endosc, 71, pp.207~209 (2010)
- Omar Ibrahim Saadah, "Histologically confirmed upper gastrointestinal Crohn’s disease: is it rare or are we just not searching hard enough?", Intestinal research, 18(2), pp.210~218 (2020), 대한장연구학회[DOI]
- Devbhandari MP, "Congenital bronchoesophageal fistula in a patient with Crohn’s disease : a cautionary tale", Ann Thorac Surg, 79, pp.1776~1777 (2005)
- Kato H, "Congenital bronchoesophageal fistula with Crohn’s disease in an adult : report of a case", Surg Today, 31, pp.446~449 (2001)
- Ashish Agarwal, "High risk of tuberculosis during infliximab therapy despite tuberculosis screening in inflammatory bowel disease patients in India", Intestinal research, 16(4), pp.588~598 (2018), 대한장연구학회
- Saad Alrajhi, "Concordance between tuberculin skin test and interferon-gamma release assay for latent tuberculosis screening in inflammatory bowel disease", Intestinal research, 18(3), pp.306~314 (2020), 대한장연구학회[DOI]
- Bibas BJ, "Surgery for intrathoracic tracheoesophageal and bronchoesophageal fistula", Ann Transl Med, 6, pp.210~ (2018)
- Spaander MCW, "Esophageal stenting for benign and malignant disease : European Society of Gastrointestinal Endoscopy(ESGE)guideline-update 2021", Endoscopy, 53, pp.751~762 (2021)