Bronchiectasis in Crohn disease

Case contributed by Dr Ammar Haouimi

Presentation

Acute on chronic abdominal pain mainly in the right iliac fossa.

Patient Data

Age: 40 years
Gender: Male

Circumferential thickening with enhancement of the terminal ileum (length = 8 cm) as well as the coecum and ascending colon with submucosal "fat halo sign", adjacent phlegmon formations and prominent engorgement of the mesenteric vasculature with surrounding fat stranding. Note also mural thickening with enhancement of a jejunal loop (length = 3 cm).

Few enlarged mesenteric lymph nodes are noted as well as mild free fluid in the pelvic region.

Ectopic, malrotated right kidney.

Lung window demonstrates a cystic bronchiectasis of the right lower lobe.

The bone window shows bilateral and symmetrical sacroiliitis as well as features of Romanus spondylitis.

Case Discussion

Thoracic manifestations in Crohn disease are rare, usually due to infection and may precede the intestinal manifestations. The pathogenesis of pulmonary involvement may be related to its common embryonic origin with the intestinal system from the primitive foregut. 

The respiratory manifestations may include:

  • bronchiectasis
  • chronic bronchitis
  • interstitial lung disease
  • cryptogenic organizing pneumonia
  • necrobiotic nodules
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Case information

rID: 60311
Published: 4th Jun 2018
Last edited: 16th Jul 2018
Inclusion in quiz mode: Excluded
Institution: Aurès Medical Imaging Center - Batna Algeria

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