Massive upper gastrointestinal bleeding secondary to a esophago-arterial fistula (arteria lusoria)

A 50-year-old patient with a history of hypopharyngeal cancer, laryngectomy, adjuvant chemoradiotherapy and incompetent tracheoesophageal fistula was admitted for elective pharingostomal surgery. During the surgery, he presented esophageal bleeding hemodynamic instability. After stabilization, gastroscopy performed through stoma, showing arterial 4-5 cm distal to which controlled three hemostatic clips. four hours, new episode instability Sengstaken-Blakemore tube placed that stopped bleeding. Computed tomography angiography (CT angiography) performed, showed an aberrant right subclavian artery retroesophageal pathway, in close contact area where clips were placed. An endovascular stent control after removal tube. The discharged seven days later.