A 71-year-old man who had undergone repair of a ruptured abdominal aortic aneurysm with a tube graft 3 months ago was transferred from another hospital with an Aortoenteric Fistula (AEF) for surgical treatment. Computed tomographic (CT) angiography revealed pseudoaneurysm formation at the proximal anastomotic site. Waiting for the elective operation, he developed massive hematemesis with shock. Endovascular stent-graft repair was emergently performed because of high risk for conventional open surgery. Gastrointestinal bleeding was successfully controlled. The psuedoaneurysm disappeared, which was confirmed by postoperative CT angiography. At 1-year follow-up, he has shown no clinical and radiographic evidence of recurrent infection or bleeding. For the case with shock, Endovascular repair could be a bridge to open surgery because it is fast and minimally invasive. Endovascular repair of AEF is technically feasible and may be the definitive treatment in selected patients without signs of infection and gastrointestinal bleeding.

A 68-year-old man was brought to our emergency department because of an accidental nail-gun injury to the chest. Chest computed tomography in the hybrid emergency room revealed a 9 cm length of nail that had penetrated the anterior chest wall, left ventricle, and descending aorta, and was lodged in the 11th thoracic vertebral body. Immediate surgical repair was performed under left anterolateral thoracotomy using partial cardiopulmonary bypass, and closure of the penetrating site in the left ventricle and aorta was successfully conpleted. He had no major complications postoperatively.