case_images: PMC3959410_01
case_images: PMC3959410_02
case_images: Initial chest radiograph. Increasing areas of confluent airspace disease involving the right middle and lower lobes and stable patchy airspace opacities involving both lungs with stable reactive lymphadenopathy
case_images: AnnGastroenterol-25-361-g001.jpg
case_images: PMC3959410_02_AnnGastroenterol-25-361-g001.jpg
case_images: F1
case_images: Initial chest radiograph showed bilateral basilar airspace opacities worse on the right and blunting of the right costophrenic angle (Fig. 1).
case_images: CT enterography. Colobronchial fistula tract (arrows) coursing from hepatic flexure and extending on the liver anteriorly and eventually communicating to right lower lobe bronchus with surrounding lung consolidation. Figures A and B demonstrate gastrointestinal contrast in the lung parenchyma. Figures C and D show fistula tract containing contrast from colon over the right lobe of the liver
case_images: AnnGastroenterol-25-361-g002.jpg
case_images: PMC3959410_02_AnnGastroenterol-25-361-g002.jpg
case_images: F2
case_images: Bronchoscopy and sputum cultures grew polymicrobial enteric organisms and abdominal CT enterography was the diagnostic test that confirmed a right colobronchial fistula (Fig. 2) and also multiple other colonic fistulas.
case_images: Chest radiograph after recovery
case_images: AnnGastroenterol-25-361-g003.jpg
case_images: PMC3959410_02_AnnGastroenterol-25-361-g003.jpg
case_images: F3
case_images: Significant improvement was evident after a twenty pound weight gain, mild intermittent non-productive cough, no recurrence of fevers and malaise, and normalization of chest radiograph (Fig. 3).