Introduction: Gastroduodenal artery embolization is an increasingly common treatment method in patients with upper gastrointestinal (GI) bleeding who fail endoscopy or as a prophylactic procedure to help prevent further episodes. However, this new technique includes new risks including GI tract ischemia and risks associated with endovascular access such as hematoma formation, pseudoaneurysm development, and arterial dissection.

Case Report: We discuss a case of 51-year-old male with recurrent upper GI bleeding who presented to the emergency department for scrotal swelling following the prophylactic embolization of his gastroduodenal artery. He was subsequently found to have a ruptured testicular artery pseudoaneurysm resulting in hemorrhagic shock, which required massive transfusion protocol and vascular repair.

Conclusion: While endovascular access is relatively safe, patients can develop severe complications such as pseudoaneurysm development and subsequent rupture that may not be obviously apparent on physical exam. Because of this, clinicians must have a high index of suspicion for arterial injury, and risk stratification should be used when selecting appropriate candidates for prophylactic procedures.

Case Presentation: We present a case of a 10-year-old male who developed an atraumatic, nasal septal hematoma with abscess following several days of rhinorrhea and cough. His chief complaint to the emergency department was a two-day history of nasal swelling and discomfort, associated with difficulty breathing through his nose. The patient was well-appearing with swelling and tenderness along the external nasal ridge and nasal septal swelling that occluded both nares. Contrast-enhanced maxillofacial computed tomography revealed a rim-enhancing, fluid-filled collection to the anterior nasal septum. The patient underwent successful incision and drainage by otolaryngology.

Discussion: Infected septal hematomas are rare but important to recognize as they can result in septal deformity and potentially life-threatening sequelae, such as intracranial infections. Most are secondary to nasal trauma in adult patients. This case highlights a unique presentation of atraumatic septal hematoma with abscess formation in an immunocompetent pediatric patient.

Introduction: Acute aortic syndrome (AAS) includes the disease processes of aortic dissection, penetrating atherosclerotic ulcer, and intramural hematoma. This case demonstrates an atypical presentation of the disease and offers approaches to potentially prevent missed diagnoses.

Case Report: An 87-year-old female with hypertension and Alzheimer’s dementia presented to the emergency department with stable vital signs and a chief complaint of throat pain. Initial work-up was significant for ischemia on electrocardiogram and elevated troponin. Computed tomography of the soft tissue neck revealed evidence of a ruptured aorta.

Conclusion: Aortic rupture is a fatal complication of AAS. In an elderly patient with a history of hypertension, ischemic changes on electrocardiogram, and nonspecific pain, AAS should be on the emergency physician’s differential even in the setting of a benign or limited history and exam.