Méga-œsophage révélé par une pleurésie

We report the case of a 65-year old patient without a history of alcohol consumption and cigarette smoking but with a history of gastroesophageal reflux disease for which he had never been examined. He was admitted to the Department of Pneumology for exploration of a dry hacking cough causing insomnia associated with diffuse heaviness in his right chest evolving over a month in a context of evening and night fever without weight loss. Clinical and radiological examination showed right pleural effusion syndrome. Radiographic follow-up after evacuating pleural effusion by puncture showed inhomogeneous opacity occupying nearly all the right lung (A). Chest CT scan objectified thoracic megaesophagus associated with non-specific pleuro-pulmonary disease. The patient underwent upper gastrointestinal endoscopy that didn’t show suspect cancer signs. Pleuro-pulmonary disease outcome was favorable after amoxicillin treatment.