• Debarati Chakraborty, Jessica Shepherd, Jamie Gregor, and Inderdeep Dhaliwal.
• Department of Medicine, Division of Respirology, Schulich School of Medicine and Dentistry, Western University, London, ON, Canada. Electronic address: dchakra2@uwo.ca.
• Chest. 2021 Sep 1; 160 (3): e255-e258.

AbstractPulmonary extra-intestinal manifestations of inflammatory bowel disease are rare, comprising 0.21% to 0.4% of the inflammatory bowel disease population. Common symptoms include cough, chest pain, and dyspnea. Abnormal pulmonary function tests are common in these patients, with restrictive, obstructive, and diffusion capacity defects. CT scanning remains the most sensitive imaging technique to detect abnormalities. Pulmonary manifestations are diverse and include airway, parenchymal, and pleural disease. Large airway disease predominates, particularly bronchiectasis. Upper airway disease is rare but concerning for the development of acute airway compromise. To our knowledge, there are no reports of concurrent mediastinitis with tracheitis in the setting of inflammatory bowel disease. We present a case of a patient with ulcerative proctitis who experienced the development of inflammatory tracheitis and mediastinitis. Her disease responded to systemic steroids and biologic therapy. In addition to our case, we reviewed the literature and provide an approach to pulmonary complications as extra-intestinal manifestation of inflammatory bowel disease.Copyright © 2021 American College of Chest Physicians. Published by Elsevier Inc. All rights reserved.

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