Herein, we report our experience of a patient whose recurrent pelvic cancer was complicated by obturator hernia after cervical cancer surgery. Regardless of the type of carcinoma, recurrent pelvic cancer tends to be complicated by neuropathic pain. On the other hand, obturator hernia is also often complicated by the similar neuropathic pain, which is referred to as Howship-Romberg symptom. However, it is relatively a rare disease that is considered difficult to make a diagnosis. In the case of this report, the patient had already developed neuropathic pain in the inside of the left thigh when she was admitted to our hospital, and began to develop a similar symptom on the right side during the course of follow-up. Despite the additional administration of analgesic adjuvant, the pain in the right thigh did not improve, and she began to develop heat sensation and redness in the extensive area from the thigh to the knee. CT scan revealed subcutaneous emphysema image and abscess formation. Based on the results of the examination, the patient’s right thigh was diagnosed as caused by the digestive tract incarcerated by obturator hernia rupturing into the right limb. The differentiation of obturator hernia is difficult to make, but its early stage diagnosis might make it possible to evade the aggravation of the symptom by manual reposition. In conclusion, when recurrent pelvic cancer was found to be complicated by neuropathic pain, it is critical to make an appropriate diagnosis taking into account the potential obturator hernia at an early stage.

Knitted Polyester prosthetic grafts can cause long-term dilatations and formation of anastomotic or non-anastomotic aneurysms, and rupture in result. We experienced a case of anastomotic pseudoaneurysm and recurrent non-anastomotic dilatation of the ascending aorta-abdominal aorta bypass by Cooley Double Velour Knitted Dacron (CDVKD) graft for a patient with atypical coarctation of the aorta (Takayasu Aortitis, type III), which case needed treatment two times over 30 years after the initial operation. The first additional treatment was Thoracic Endovascular Aortic Repair (TEVAR) for non-anastomotic aneurysm was done as 1st operation. Thirty-two years after the initial operation, the second treatment was a hybrid operation consisting of 4 procedures: bilateral axillo-external iliac bypass, taking down of the CDVKD graft at the proximal anastomotic site, endovascular repair (EVAR) with modified Double D Technique, and coil packing at the distal anastomotic site of the CDVKD graft. The patient was discharged at 37-POD. No complication and no endoleak has occurred in the 2.5 years since the operation.

Among the less reported complications after thoracic endovascular aortic repair (TEVAR) is type II endoleak (T2EL). The intercostal and bronchial artery are known as feeder vessels to T2EL after TEVAR. We experienced two cases of successful treatment of percutaneous transarterial feeder vessels embolization via right costocervical trunk approach for patients with persistent T2EL and sac enlargement of an arch aneurysm after TEVAR. The costocervical trunk route is possible for key vessels to construct a collateral pathway to feeder vessels of the endoleak nidus of T2EL after TEVAR procedures for aortic arch aneurysm. A preembolizational Catheter-Directed CT angiogram (CTA) can be helpful to prevent harmful complications (e.g., spinal cord infarction).