Balloon-expandable visceral artery stents are susceptible to crush injury during aortic surgery. Consideration should be given to early imaging after such surgery in FEVAR patients.

Background/Aim Hepatocellular carcinoma (HCC) is one of the most common forms of liver cancer that is modulated by the immune system. Programmed cell death ligand-1 (PD-L1) has emerged as a novel therapeutic target in various cancers. Indoleamine 2,3-dioxygenase (IDO) is an immunosuppressive enzyme that is associated with poor prognoses in various cancer types. The aim of this study was to investigate the PD-L1 expression, and clinicopathological features of non-HCV and non-HBV-associated HCC patients, including IDO expression. Patients and Methods In this study, immunohistochemical analysis was performed to analyze the expression of PD-L1 and IDO. Formalin-fixed paraffin-embedded HCC tumor tissues (n=50) were obtained from the pathology department, at Shaukat Khanum Memorial Cancer Hospital and Research Centre (SKMCH&RC) in Lahore, Pakistan between 2005 and 2022. All the patients were HBV and HCV negative. Furthermore, it was a rare group of patients with no previous history of any viral hepatitis. In addition, for categorical and continuous variables chi-square or Fisher exact test and Mann–Whitney U -test was performed. Results Of 50 tissue specimens, PD-L1+ was observed in 21 [high: 12 (24%), low: 9 (18%)] and PD-L1- was observed in 29 HCC patients. IDO+ was observed in all 50 specimens [high: 42 (84%), low: 8 (16%)]. Additionally, both PD-L1 and IDO had high expression in 11 (22%) patients. While both PD-L1 and IDO had low expression in 2 (4%) patients. Furthermore, in IDO+/PD-L1- group, 20 (69%) out of 29 patients died while in the IDO+/PD-L1+ group, 9 (43%) out of 21 patients died. Conclusion Evaluation of IDO and PD-L1 expression may add therapeutic advantage in non-HCV and non-HBV-associated HCC patients that overexpress IDO. Further validation in a larger cohort is warranted.

A new cause for enophthalmos is described.

Objective: To determine the diagnostic accuracy of multidetector computed tomography in detection of esophageal varices in patients with hrpatic cirrhosis. Study Design: Cross Sectional study. Setting: Department of Diagnostic Radiology, Kot Khawaja Saeed Teaching Hospital, Lahore. Period: January, 2021 to July, 2021. Material & Methods: Two hundred seventy five patients diagnosed with liver cirrhosis were included in our study. Multidetector CT of the abdomen was performed using multislice CT and the findings were recorded. The cases underwent endoscopy within the subsequent 8 weeks. The results of MDCT were compared with endoscopy findings, which were taken as gold standard. Results: We found 190 true-positives, 80 true-negatives, 03 false-negatives, and 02 false-positive results. MDCT demonstrated a sensitivity of 98.4%, a specificity of 97.6%, PPV of 99.0%, NPV of 96.4%, and an accuracy of 98.1%. Extra-esophageal findings on MDCT included other porto-systemic collaterals and hepatocellular carcinoma. Conclusion: MDCT is an effective modality for diagnosis of esophageal varices and can be used as a screening test for varices. CT also permits evaluation of extra-luminal pathology that impacts management.