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We report a 40-year-old lady with post-partum cardiomyopathy for more than 4 years and had left ventricular assist device (LVAD) implantation. She was New York Heart Association Class IV and Interagency Registry for Mechanically Assisted Circulatory Support Level I. She had HeartWare (HeartWare Inc, Framingham, MA, USA) LVAD implantation. She was admitted to emergency department with dysfunctional uterine bleeding with a hemoglobin level 3 gr/dL and a hematocrit level 10%, 3 months postoperatively. The ultrasonographic evaluation revealed blood coagulum in the uterine cavity, she was diagnosed with dysfunctional uterine bleeding, and hospitalized. Since there was a probability of LVAD pump thrombosis, a surgical intervention was not planned. Gonadotropin releasing hormone analogue therapy and embolisation of bilateral uterine arteries prevented further dysfunctional uterine bleeding. We report the first case in the literature with advanced heart failure supported with LVAD and bilateral uterine artery embolization due to dysfunctional uterus artery bleeding with an endovascular procedure. [Turk J Vasc Surg 2019; 28(1.000): 51-4]

Background and Aim: To derive lessons from the data of patients who were followed for various periods with the misdiagnosis of liver hemangioma and eventually found to have a malignancy.Material and Methods: The records of 23 patients treated between 2003 and 2018 were analyzed retrospectively.Results: Twelve patients were men and 11 were women; median (range) age was 55 (35–80). The principal diagnostic modality for the initial diagnosis was ultrasonography (n:8), magnetic resonance imaging (MRI) (n:13), and computed tomography (CT) (n:2). At our institution, MRI was performed in 16 patients; the diagnosis was made with the available MRI and CT studies in five and two patients, respectively. In other words, the ultrasonography interpretations were not confirmed on MRI; in others, the MRI or CT examinations were of low quality or they had not been interpreted properly. Fifteen patients underwent surgery; the other patients received chemotherapy (n:6) or chemoembolization (n:2). The misdiagnosis caused a median (range) 10 (0–96) months delay in treatment. The final diagnoses were hepatocellular carcinoma in 12 patients, cholangiocarcinoma in four patients, metastatic mesenchymal tumor, metastasis of colon cancer, metastatic neuroendocrine carcinoma, sarcomatoid hepatocellular carcinoma, angiosarcoma, thoracic wall tumor, and metastatic tumor of unknown primary in one patient each.Conclusions: High-quality MRI with proper interpretation and judicious follow up are vital for the accurate differential diagnosis of liver lesions.

Abstract Long‐term albendazole treatment should be given to all patients with unresectable hepatic alveolar echinococcosis as dramatic regression is possible in 15%–20%. It may be prudent to prepare a living donor for possible salvage transplant in case of a severe complication. Preemptive transplantation in mildly symptomatic patients should be discouraged.

Abstract The steroid‐induced, rapid healing of the biliary tree ravaged by IgG4‐related disease shows that the point of irreversibility remains to be defined.

PurposeThe objective of this study was to characterize the electrophysiological characteristics of nonrecurrent inferior laryngeal nerves (NRILNs) that were dissected via intraoperative neuromonitoring (IONM) and concomitant vascular anomalies in patients with NRILNs.MethodsA retrospective analysis was conducted on 7865 patients who underwent thyroidectomy with IONM at three tertiary referral centers. The study included 42 patients in whom an NRILN was detected. IONM data and postoperative vocal cord (VC) examinations were recorded for all patients. The absence of an initial vagal EMG response and/or a short (3.5ms had a large mediastinal goiter. Transient VC paralysis occurred in one (2.4%) patient. Of the 36 patients with postoperative imaging data, 33 (91.4%) had vascular anomalies. All 33 patients had aberrant right subclavian arteries, and 13 (39.4%) also had accompanying additional vascular anomalies.ConclusionThe NRILN is an anatomical variation that increases the risk of nerve injury. Observation of an absent EMG response and/or a short latency period during the initial vagal stimulation facilitates the detection of an NRILN at an early stage of thyroidectomy in the majority of patients.