[Congenital esophagobronchial fistula in an adult. Case report]. / Fistule oeso-bronchique congénitale chez l'adulte. A propos d'un cas.

Congenital esophagobronchial fistulae are uncommon anomalies generally discovered during the neonatal period due to overt symptoms. Rarely symptoms are discrete, leading to discovery in adulthood; exceptionally the patients are totally symptom free or present minimal signs such as coughing at ingestion of fluids. Less than 200 adult cases have been reported in the literature. We report a new case of this type II congenital esophagobronchial fistula. A 59-year-old woman was hospitalized for exploration of cough at ingestion of fluids. The radiographic work-up reveal dilatation of the left bronchial tree and suspected esophagobronchial fistula. An esophago-gastro-duodenal barium study demonstrated a fistula between the mid esophagus and the left posterobasal bronchus. Fistulectomy and left lower lobectomy were performed. Outcome was favorable. The diagnosis of adult esophagobronchial fistula should be entertained in patients with an uneventful history who present localized bronchial dilatation associated with cough induced by fluid ingestion.

[Associated rhinosinus and pleural sarcoidosis]. / Association de localisations rhino-sinusienne et pleurale au cours d'un cas de sarcoïdose.

Sarcoidosis manifestations in the upper airways and pleura are exceptional, observed in 5% and 1% of cases. We report an exceptional observation of an association of these two localizations in addition to mediastinopulmonary involvement. After confirmation of the diagnosis obtained on bronchial biopsies and nasal mucosa biopsies, pleural sarcoidosis was retained because of the clinical context and the spontaneous resolution of the effusion. The major problem is the absence of a therapeutic consensus on proper management, oral corticosteroid therapy being proposed by some for these particular forms of sarcoidosis.