Abstract
A 70-year-old man vomited an amount of blood suddenly at home, and was transported to our hospital by ambulance. As a medical history, 7 years earlier, he had undergone radiation therapy and right neck dissection for the treatment of hypopharyngeal cancer. Four months earlier, due to recurrence of hypopharyngeal cancer, he had undergone total pharyngo-laryngo esophagectomy and reconstruction surgery with free jejunum. At the first visit, the bleeding had already stopped, so we considered that the bleeding had occurred at the mucosa of the transplanted free jejunum. However, 28 hours later, he vomited blood again. We examined his transplanted free jejunum under general anesthesia and diagnosed that the transplanted free jejunum had an ulcer and fistula, and bleeding was due to a ruptured aneurysm of the external carotid artery. The external carotid artery was embolized with endovascular treatment and the bleeding was stopped. Two days after embolization, we performed partial resection of the necrotic free jejunum and reconstruction with a pectoral major myocutaneous flap.
