Splenic artery aneurysms are rare clinical entities that carry the risk of rupture and fatal hemorrhage. Due to the availability of advanced imaging techniques, they are now being found more frequently and identified earlier. Historically, the surgical approach to their management has consisted of laparotomy with resection of the aneurysm and a possible splenectomy. Recently, angiographic interventions and laparoscopic exclusion of splenic artery aneurysm has been shown to provide adequate therapy without the morbidity associated with open aneurysmectomy and splenectomy. In patients with previous abdominal surgery, a planned hand-assisted approach may be needed. We present the cases of two patients with splenic artery aneurysms who were successfully managed laparoscopically. The hand-assisted approach was needed in our second patient, who had a history of gastric bypass surgery. Both patients had an uneventful postoperative course and were discharged home on postoperative day one.

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Males undergoing CT scans are significantly more likely to have perforated appendicitis. A protocol-driven rational approach to CT evaluation of suspected appendicitis may lower perforation rates, especially in males.