Aorto-oesophageal fistula: rarest cause of haematemesis - is it salvageable?

A 60-year-old man presented with severe abdominal pain, two episodes of massive haematemesis and chest discomfort. CT angiography showed a saccular aneurysm of the juxtaphrenic aorta with possible oesophageal erosion. Upper GI endoscopy revealed external compression of the lower oesophagus—near total luminal obstruction with impending rupture of the aortic aneurysm. Emergency aneurysmal repair by interposition grafting using 20 mm Dacron graft with oesophageal–gastric reconstruction done. Postoperative period was uneventful

Challenges in Managing Massive Neck Pseudoaneurysm

Pseudoaneurysms in the neck are challenging surgical cases. They need detailed preoperative evaluation, treatment of etiology, and surgical/interventional management at appropriate time.Here, we describe a case of 45-year-old female who presented to emergency with impending rupture of swelling in the right side of neck. On evaluation, it was found to be a pseudoaneurysm of right common carotid artery (RCCA). She was planned for emergency surgery, but the swelling ruptured before the patient could be taken into the operation room (OR). The challenges faced in managing it are described below.

Impending rupture of a chronic contained abdominal aortic aneurysm with a 14-day history

A 73-year-old man reported left low back pain worsening since 2 weeks. Ten days prior, he felt indefinable anxiety, which abated, but the back pain persisted. His diaphoretic and vasoconstrictive hands suggested hypovolemic shock. Emergency computed tomography revealed impending rupture of an abdominal aortic aneurysm. Emergent surgery saved his life.