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Spontaneous hemopneumothorax is a rare disease and intrathoracic bleeding reportedly occurs in the detached region of adhesive parietal pleura, aberrant vessel and cystic wall. We experienced two cases of bleeding most likely from the aberrant vessel. One patient was a 25-year-old male who had severe chest pain with dyspnea for four days. Chest X-ray revealed left pneumothorax and mediastinal shift to the right. Approximately 1500 ml of blood was aspirated from the left thoracic cavity. Since bleeding continued, emergency thoracotomy was performed. A restiform structure was noted in the bulla at the apex of the lung and the stump of the structure was considered as the source of bleeding. The other patient was a 29-year-old male who underwent emergency operation 16 hours after the massive bleeding amounting to 1800 ml. At the thoracotomy, a ruptured bulla at the apex of the collapsed lung with restiform structure was encountered. The bleeding point in the stump of the structure was ligated and the ruptured bulla was resected. In the histological study of these patients, an aberrant blood vessel was revealed in the restiform structure, which suggests the etiology of the bleeding. Their postoperative course was uneventful and had no symptom at the discharge. In the management of spontaneous hemopneumothorax, early thoracotomy should be the first consideration taking into account the massive bleeding from the aberrant vessel as in the cases.

A case of long ureteral polyp with ureteropelvic junction obstruction in a 29-year-old man is reported. He had complained of occasional left flank pain since several years earlier. Excretory urography showed left giant hydronephrosis and no urolithiasis. Retrograde pyelography revealed a mass lesion of the left upper ureter. At exploration, the left ureteropelvic junction was found to be obstructed by an aberrant lower pole renal vessel. At just distal of the junction, a finger-like ureteral polyp, 5 cm in maximal length, was present and accompanied with several little polyps. Partial ureterectomy and pyeloplasty improved the left hydronephrosis. The patient remains symptomless for one year after the operation.