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We present two patients with acute rapidly enlarging rectus sheath hematomas. Case 1 developed the hematoma following ultrasound-guided liver biopsy, while in case 2 the hemorrhage was spontaneous. Both were anti-coagulated. Computed tomography of the abdomen with arterial phase scans were valuable in defining the sites of hemorrhage and planning endovascular treatment. The radiological findings and intervention are discussed with review of the relevant literature.

Purpose. To describe a case of splenic artery aneurysm treated successfully with percutaneous coil embolization and briefly discuss the management of such aneurysms. Case report. A 71-year-old man presented for management of a large (> 2.5 cm) splenic artery aneurysm found incidentally during abdominal computed tomography (CT). His aneurysm was successfully treated with coil embolization, and follow-up CT revealed opacification of the aneurysmal sac with flow into the splenic artery distal to the aneurysm. Conclusion. The management of splenic artery aneurysms may include open or laparoscopic surgical or percutaneous techniques. As the incidence of splenic artery aneurysms is likely to rise with the increasing use of abdominal imaging, the optimal management strategy will need to be defined. Percutaneous techniques are an attractive first approach.

The thoracic aorta presents an assortment of pathology that can be quite challenging and difficult to treat. Thoracic aortic aneurysms lead to significant morbidity and mortality if allowed to progress to rupture. Historically, open surgical repair has a reported mortality of 3–12%, and a paraplegia rate of 2.6–3.8%. These rates occur in series using state of the art techniques, including distal perfusion and cerebral spinal fluid drainage. With the magnitude of the open repair, it is impressive that the complication rates are as low as reported. The continual drive to improve the results in the treatment of thoracic aneurysms has lead to the development of a new endovascular technique for excluding these aneurysms called Thoracic Endovascular Aortic Repair (TEVAR). This technique requires the creation of new endograft devices that are designed to withstand the tremendous forces generated in the thoracic aorta. Currently, there is one thoracic endograft device that is FDA approved fo