Fibrovascular polyps are extremely rare benign neoplasms of the esophagus. The most prominent clinical symptom is enoral tumor regurgitation, which may lead to asphyxiation by pharyngeal impaction. Usually fibrovascular polyps cause dysphagia and progressive weight loss. Diagnosis by endoscopy and barium swallow may be unexpectedly difficult. The most frequent incorrect diagnoses are achalasia or an intramural or mediastinal tumorous mass compressing the esophagus. CT scan and MR imaging are of little help. Small polyps may be resected endoscopically by means of electrocautery or Nd:YAG laser ablation. In most cases, however, surgical resection is required. Since the basis of the polyp is usually located subcricoidally, tumor exposure and resection are achieved by esophagotomy via a left cervical approach. Thoracotomy is seldom required.

Arteriovenous fistula is a rare complication following vascular trauma. We report a case of an arteriovenous fistula of the neck after a penetrating injury. The only presenting symptoms were a thrill and a machinery murmur. There were no signs of cardiac insufficiency. Duplex scan and arteriography detected an arteriovenous fistula between the superior thyroid artery and the superior thyroid vein. Surgical therapy was straight-forward. Treatment should be carried out as soon as possible, and is then usually simple and successful.

The appropriate treatment of an injury to a single arterial vessel of the calf is still a matter of discussion. Isolated injury of one of the calf arteries is generally not considered to cause severe ischemia of the leg. Other factors such as the degree of concomitant trauma to bones, nerves, veins and soft tissue, which may impair collateral circulation, seem to represent the real threat for the survival of the extremity. On the other hand, high numbers of amputations were reported after the Second World War following ligation of an injured single vessel of the calf. Concomitant injuries are poorly documented in these reports. Consequently a good physical examination as well as arteriography, duplex ultrasound scan and a high index of suspicion are mandatory to evaluate the impaired circulation of the calf and to prevent hasty ligation of a single vessel.

Even among the uncommon aneurysms of the visceral arteries the aneurysm of the pancreaticoduodenalis artery is considered a rarity. Etiologically, numerous factors must be taken into account, the most significant one being arteriosclerosis. The clinical presentation is unspecific and ambiguous. CT and, above all, intra-arterial DSA allow for a diagnosis. A generous consideration of indicating operative intervention, even in asymptomatic patients, is especially justified because of the imminent risk of rupture. The preferable therapy consists of elimination of the aneurysm either conventionally by proximal and distal ligature of the pancreaticoduodenalis artery or endovascularly by embolization. In the future a treatment with coated stents (TPEG) would also seem possible. Special attention must be paid to concomitant occlusive disease in other visceral arteries since measures for vessel reconstruction may be required because of intraoperative impairment of the collateral circulation. We report on the rupture of an aneurysm of the pancreaticoduodenal inferior artery in association with celiac axis occlusion.