Fistulizing and Stricturing Esophageal Crohn's Disease Requiring Esophagectomy

Esophageal Crohn's disease is uncommon and difficult to identify, especially in the adult population. In this study, we report a biologic-naïve patient with colonic Crohn's disease complicated by recurrent esophageal strictures despite many dilations, who presented to our center with recurrent aspiration pneumonia. He was found to have a tracheoesophageal fistula as the likely etiology. After multidisciplinary discussion, he underwent esophagectomy given the severity of his stenosis. The patient's surgical course was complicated by dysphonia and aspiration due to unilateral vocal cord paralysis, which resolved with vocal cord injection. This case highlights a severe manifestation of esophageal Crohn's disease.