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Right-sided colopleural fistula secondary to diverticular disease: a case report

BACKGROUND: Colopleural fistulas are mostly left-sided and related to trauma, Crohn’s disease, or gastrointestinal malignancy. However, a diverticular fistula between the colon and right pleural space has not been reported and is rare considering the liver forms a natural anatomical barrier on this...

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Autores principales: Hassan, Summer, Singh, Primal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9701423/
https://www.ncbi.nlm.nih.gov/pubmed/36435824
http://dx.doi.org/10.1186/s13256-022-03668-1
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author Hassan, Summer
Singh, Primal
author_facet Hassan, Summer
Singh, Primal
author_sort Hassan, Summer
collection PubMed
description BACKGROUND: Colopleural fistulas are mostly left-sided and related to trauma, Crohn’s disease, or gastrointestinal malignancy. However, a diverticular fistula between the colon and right pleural space has not been reported and is rare considering the liver forms a natural anatomical barrier on this side. Colopleural fistulas often present with respiratory symptoms ranging from mild cough and dyspnea to sepsis from empyema caused by the leakage of gastrointestinal content into the pleural space. Although colopleural fistulas are rare, maintaining low suspicion is pivotal for timely investigation and appropriate surgical planning, particularly in the context of previous intra-abdominal infections or trauma. CASE PRESENTATION: A 67-year-old Chinese male presenting with prolonged respiratory symptoms was found to have a right-sided colopleural fistula confirmed by computed tomography imaging and a colonoscopy. It was addressed surgically after multidisciplinary consensus was reached, with a right hemicolectomy and repair of the diaphragmatic defect. The patient recovered remarkably well with resolution of respiratory symptoms. CONCLUSION: Appropriate work-up of a suspected colopleural fistula with radiological and endoscopic investigations to determine anatomy and etiology is crucial. Most cases will require surgical management, and involvement of the respiratory and cardiothoracic teams is important to optimize lung function preoperatively and plan for possible chest complications.
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spelling pubmed-97014232022-11-28 Right-sided colopleural fistula secondary to diverticular disease: a case report Hassan, Summer Singh, Primal J Med Case Rep Case Report BACKGROUND: Colopleural fistulas are mostly left-sided and related to trauma, Crohn’s disease, or gastrointestinal malignancy. However, a diverticular fistula between the colon and right pleural space has not been reported and is rare considering the liver forms a natural anatomical barrier on this side. Colopleural fistulas often present with respiratory symptoms ranging from mild cough and dyspnea to sepsis from empyema caused by the leakage of gastrointestinal content into the pleural space. Although colopleural fistulas are rare, maintaining low suspicion is pivotal for timely investigation and appropriate surgical planning, particularly in the context of previous intra-abdominal infections or trauma. CASE PRESENTATION: A 67-year-old Chinese male presenting with prolonged respiratory symptoms was found to have a right-sided colopleural fistula confirmed by computed tomography imaging and a colonoscopy. It was addressed surgically after multidisciplinary consensus was reached, with a right hemicolectomy and repair of the diaphragmatic defect. The patient recovered remarkably well with resolution of respiratory symptoms. CONCLUSION: Appropriate work-up of a suspected colopleural fistula with radiological and endoscopic investigations to determine anatomy and etiology is crucial. Most cases will require surgical management, and involvement of the respiratory and cardiothoracic teams is important to optimize lung function preoperatively and plan for possible chest complications. BioMed Central 2022-11-27 /pmc/articles/PMC9701423/ /pubmed/36435824 http://dx.doi.org/10.1186/s13256-022-03668-1 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.
spellingShingle Case Report
Hassan, Summer
Singh, Primal
Right-sided colopleural fistula secondary to diverticular disease: a case report
title Right-sided colopleural fistula secondary to diverticular disease: a case report
title_full Right-sided colopleural fistula secondary to diverticular disease: a case report
title_fullStr Right-sided colopleural fistula secondary to diverticular disease: a case report
title_full_unstemmed Right-sided colopleural fistula secondary to diverticular disease: a case report
title_short Right-sided colopleural fistula secondary to diverticular disease: a case report
title_sort right-sided colopleural fistula secondary to diverticular disease: a case report
topic Case Report
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9701423/
https://www.ncbi.nlm.nih.gov/pubmed/36435824
http://dx.doi.org/10.1186/s13256-022-03668-1
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