Acute upper gastrointestinal bleeding caused by esophageal right bronchial artery fistula: A case report.

BACKGROUND: Fistula between the esophagus and bronchial artery is an extremely rare and potentially life-threatening cause of acute upper gastrointestinal bleeding. Here, we report a case of fistula formation between the esophagus and a nonaneurysmal right bronchial artery (RBA). CASE SUMMARY: An 80-year-old woman with previous left pneumonectomy and recent placement of an uncovered self-expandable metallic stent for esophageal adenocarcinoma was admitted due to hematemesis. Emergent computed tomography showed indirect signs of fistulization between the esophagus and a nonaneurysmal RBA, in the absence of active bleeding. Endoscopy revealed the esophageal stent correctly placed and a moderate amount of red blood within the stomach, in the absence of active bleeding or tumor ingrowth/overgrowth. After prompt multidisciplinary evaluation, a step-up approach was planned. The bleeding was successfully controlled by esophageal restenting followed by RBA embolization. No signs of rebleeding were observed and the patient was discharged home with stable hemoglobin level on postoperative day 7. CONCLUSION: This was a previously unreported case of an esophageal RBA fistula successfully managed by esophageal restenting followed by RBA embolization.

Anomaly of digastric muscle: an alarm bell for head and neck surgeon.

Objectives: Here follows the discussion of a case of hypoplasia of both bellies of digastric muscle and the difficult during neck dissection, because of his surgical importance like a pivotal landmark. METHODS: We reported a case report concerning digastric muscle abnormalities, accidentally discovered during neck dissection due to surgical excision of a glottic squamous cell carcinoma staged as cT3N0. A brief literature review was done to compare and research similar cases. RESULTS: Literature counts several reports of digastric muscle abnormalities, namely involving the anterior belly. Little has been written about hypoplasia of digastric muscle. CONCLUSION: Digastric muscle abnormalities are rare, which can be absent or, more frequently, duplicated. Albeit its anomalies are anecdotal, it is advisable to give due consideration to the hypoplasia of both bellies of the digastric muscle during the analysis of radiological imaging, in order to prevent the risk of operative complications. According to our knowledge, this is the first and singular case of digastric muscle's hypoplasia.