A 59-year-old woman was referred to our hospital with a complaint of a pulsatile mass in the right inguinal region four months after total hip replacement. Right femoral arterial injury owing to continuous contact with a fold of excess cement used in the fixation of the hip prosthesis was suspected to be the cause of the false aneurysm. Moreover, two months after the total hip replacement, the right lower leg was amputated at the below-knee level for acute ischemia due to arterial thromboembolism probably originating from the false aneurysm. False aneurysm due to direct vascular injury deserves consideration as a possible complication of total hip replacement.

A 76-year-old man was admitted to our hospital because of sudden upper abdominal pain and shock status. The patient had undergone Miles' procedure with a colostomy on the left lower abdomen due to rectal cancer at the age of 70 years. CT scans revealed a thoracoabdominal aortic aneurysm. In view of the clinical findings, ruptured aneurysm requiring emergent operation was diagnosed. A left spiral skin incision was made, keeping away from the colostomy. An extraperitoneal approach was selected. The thoracoabdominal aorta was replaced with an artificial graft under partial extracorporeal circulation with femoral arterial and venous cannulation. The postoperative course was uneventful. No paraplegia occurred in spite of no reconstruction of the intercostal arteries due to severe atherosclerotic changes of the aortic wall. The fact that bleeding due to ruptured aneurysm was localized in the extrapleural and extrapritoneal spaces seemed to be an advantageous factor for the success in this case.