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Most aneurysms shrink after successful endovascular repair. It has been observed, however, that some aneurysms continue to enlarge despite apparent exclusion of the sac by an endograft device. Unexplained abdominal aortic aneurysm (AAA) enlargement in these circumstances appears to be associated with high pressures inside the sac, and the phenomenon has been termed endotension. This paper reviews current theories and experimental evidence regarding the possible mechanisms of causation of endotension, and early experiences with treatment.

Laparoscopic fundoplication is a safe and effective alternative to long-term medical therapy in select patients with gastroesophageal reflux disease. Among the technical challenges of laparoscopic fundoplication, retraction of the left lobe of liver can cause significant morbidity. Intraoperative complications from retraction injuries have been reported in the literature, but postoperative complications arising from liver retraction have not been published. The authors present a case of a symptomatic liver hematoma requiring hospital readmission for diagnosis and pain control and a review of retraction injuries.