Abstract
A 73-year-old man, who previously had undergone a Hartmann operation for rectal cancer, showed sudden bleeding with hematemesis and blood pressure fell after the operation. When endoscopic hemostasis was enforced emergently. The pulsatile arterial hemorrhage was found in the lower thoracic esophagus, but endoscopic hemostasis was difficult and it was necessary to use transcatheter arterial embolization (TAE) emergently.
From the oesophageal branches of the right bronchial artery, leakage of contrast medium was found and was identified as the bleeding part. TAE was enforced, and hemostasis was normalized, and after leaving the hospital the progress was good. With the endoscoic findings, no ulcer was found and it was diagnosed as a false aneurysm that ruptured into the esophagus.
Esophageal hemorrhage is bleeding mostly from varices, and reports of arterial hemorrhage are rare, most of which were caused by Deulafoy ulcer, and cancer.
Moreover, most cases of ruptured bronchial aneurysm manifest hemoptysis due to rupture into the pulmonary parenchyma, the case described here displayed hematemesis, and there are almost no such reports in the past. We experienced a very rare case of esophageal hemorrhage from the esophageal branches of the right bronchial artery and succeeded in lifesaving by using TAE.
