Purpose To report the success rate of adrenal venous sampling (AVS) and identify the predictors for procedural success. Material and methods Sixty-four patients (18 men and 46 women) with a mean ± SD age of 50 ± 11.8 years (range 28-69 years) diagnosed as primary hyperaldosteronism, and who underwent AVS from January 2009 to December 2016, were retrospectively reviewed. In our institution, the initial period to perform the AVS was set from 2009 to 2013, and the post-initial period was defined as procedures performed after 2013. Successful sampling was determined when the ratio of cortisol from the adrenal vein to the level of cortisol in the inferior vena cava ≥ 5. The procedural success and subject factors between success and failure were analysed. A p value < 0.05 was considered statistically significant. Results The success rate of bilateral AVS was 71.9%. The success rates of right and left AVS were 76.6% and 90.6%, respectively. Male patients were more likely to succeed than female patients (adjusted odds ratio [aOR], 9.83; 95% confidence interval [CI], 1.14-85.14; p = 0.009). In our institution, the procedure performed in the post-initial period also succeeded more often compared to the initial period (aOR, 5.05; 95% CI, 1.2-21.16; p = 0.017). No other factors were associated with the success rate in this study. Conclusions The success rate of bilateral AVS in our institution was rather high. Male gender and procedure performed in the post-initial period were significant predictive factors for a successful procedure.
Introduction: Endometriosis is a benign condition characterized by endometrial tissue deposited outside the uterine cavity. Endometriosis characteristics include a well-defined cyst (endometrioma) with or without internal septations and seeding nodules; however, no case of extensive infiltrating abdominopelvic endometriosis have been reported.Case presentation: A 48-year-old female presented with incidentally found a hypervascular lesion in the pelvic cavity from routine checkup ultrasound. The computed tomography (CT) angiography investigation showed pelvic arteriovenous malformation (AVM). She underwent embolization at interventional radiology unit and the CT angiography follow up showed complete occlusion of pelvic AVM. However, eight months after embolization, she came with severe abdominal pain and hypotension. Emergency CT showed a large abdominopelvic mass with hemoperitoneum which was suspected for gynecologic or peritoneal malignancy. Further magnetic resonance image (MRI) was highly suspicious of peritoneum or mesentery malignancy. Surgical tumor removal was performed. The histologic results were negative for malignancy and the tumor was compatible with endometriosis.Conclusion: Extensive abdominopelvic endometriosis is rare, and its imaging findings may not exclude peritoneal malignancy. Therefore, a definite diagnosis via histological investigation is necessary.Â
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