A sudden hemorrhage in the esophageal duplication cyst: A rare cause of acute dysphagia in an adult.

A 42-year-old male pediatrics physician was admitted with a history of acute chest pain and sudden severe dysphagia to solids and liquids. He denied any history of abdominal pain, vomiting, dyspnea, nausea weight loss. He could not even swallow saliva. The patient denied any history of drug abuse. A computed tomographic scan of the chest (CT)showed a posterior mediastinal mass inseparable from the esophagus and descending aorta. Magnetic resonant imaging (MRI)scan revealed a cystic mass full of blood inseparable from the esophagus and adherent to the aorta. The mass was resected entirely through the left thoracotomy; post-operative recovery was uneventful; dysphagia resolved as the post-operative contrast swallow study showed a free flow of contrast to the stomach patient resumed his regular diet.

Two-stage surgery for delayed esophageal perforation and concomitant chylothorax secondary to upper gastrointestinal endoscopy.

A 46 years old male smoker was admitted to our hospital with a three-month history of chest discomfort and burning sensations due to regurgitation of food. The gastroenterologist tried multiple attempts to pass the endoscope through the lower end of the esophagus but failed. Post endoscopy Chest -X-ray showed right hemithorax fluid collection. A 28Fr chest drain was inserted, and fluid analysis revealed chyle. A contrast computed tomographic scan of the chest (CT) revealed esophageal perforation. The patient was managed conservatively by the primary physician on TPN, Antibiotics, and keeping him nil by mouth. After two weeks of failed conservative management, they referred the patient to the thoracic surgeon. We planned two-stage surgery because the patient was critically sick, septic, and hemodynamically unstable on inotropic support.

Cardiac arrest secondary to subclavian artery injury in blunt chest trauma: A lifesaving emergency surgery in COVID crises.

A 25-year-old male vehicle driver had a road traffic accident and sustained a blunt chest injury. His chest x-ray in the emergency department showed left hemithorax opacification. A chest drain Fr32 was inserted, and 1300ml of Blood drained out. While having a computed tomographic scan of the thorax scan, he had a cardiac arrest and after Cardiopulmonary Resuscitation (CPR) he was transferred to our tertiary care hospital on a mechanical ventilator and massive ionotropic support (adrenaline and noradrenaline) with a blood pressure of 50/24 mmHg. We performed a lifesaving emergency thoracotomy in a supine position with all COVID precautions, as COVID status was not available before hospitalization. After the repair of the Subclavian artery patient recovered completely and was discharged for follow-up in outpatient.