We describe a cervical intramedullary neurenteric cyst in a 12-year-old male patient who presented with gradual onset and progressively worsening neck pain, spastic quadriparesis and impaired sensation in the C₂ dermatome. MR imaging revealed a well-defined peripherally enhancing cystic intramedullary lesion with a posteroinferior enhancing nodule at the C₂–C₃ level mimicking an abscess. There was no evidence of spinal dysraphism. The lesion was completely resected through a posterior approach and the patient showed radical improvement in his symptomatology. At follow-up after 3 years, he was asymptomatic and the MR imaging showed no evidence of any residual or recurrent cyst. The case presented here is unique, since a spinal neurenteric cyst showing intense peripheral contrast enhancement mimicking an abscess is unusual. The radiological features, pathogenesis and surgical considerations in cervical intramedullary neurenteric cysts are discussed and the relevant literature is briefly reviewed.

Pseudoneurysms of the subclavian artery after blunting thoracic trauma presenting with a complication of hemoptysis are rare, most of which occur early, within days of trauma and represent a challenging surgical problem. Only a few scattered case reports are found in the literature. Here, we present the case of a 36-year-old male, with a history of blunt injury to the chest with right clavicular fracture, a few years back, who presented with cough, hemoptysis and shortness of breath of five days duration. On complete evaluation it was found that these complaints were due to a sub clavian artery pseudo aneurysm in the proximal part, which is compressing on the right upper lobe bronchus and blood leaking into the parenchyma and airways producing the symptoms. He was managed conservatively and stabilized. Later aneurysm resection and anastomosis was done electively. The patient is now asymptomatic and healthy.

IntroductionSpontaneous tears of the mucosal layers are well known in esophagus after severe bouts of vomiting. But severe bouts of cough leading to a tear in the bronchial tree is not commonly seen and not reported yet. We report this rare occurrence in an immunocompromised female with respiratory infection. Case presentation A 60 year old female with Chronic kidney disease secondary to Vasculitis on immunosupressive medication and maintenance hemodialysis presented with severe cough over 2 days associated with hemoptysis of moderate quantities. She had left lower lobe consolidation with mild pleural effusion on chest radiograph and Computerized Tomogram of chest (Figure1). She was in respiratory distress and required invasive ventilation. Routine investigations and coagulations parameters like PT, APTT, Platelet count were normal. She was not on any anticoagulant medication. A Flexible Bronchoscopy was performed through the Endotracheal tube. It revealed a tear ( Figure. 2) along the junction of left upper and lower lobe bronchi measuring about 1cm length and 3-4 mm wide rough floor oozing fresh blood. Broncho alveolar lavage (BAL) collected from the left lower lobe was turbid but not grossly hemorrhagic. Cytological analysis of BAL revealed few Red blood cells and predominant Neutophils. Subsequently BAL Culture had grown Pseudomonas which was treated with appropriate antibiotics. Her hemoptysis stopped eventually and she was extubated and discharged after, in stable condition. Discussion Tears in the bronchial tree are almost always trauma related and spontaneous tears are not generally heard of. On detailed review of