Adele has had to cancel a string of concerts in America for a second time after announcing on her website that she has suffered a haemorrhage to her vocal chords.
The singer was due to start a short tour across ten cities in the US on Friday.
However, the first few dates were cancelled and an official announcement has been made.
The 23-year-old was forced to call off some tour dates in the US only a few months ago, after coming down with laringitis.
She is clearly very distressed and concerned about letting her fans down, admitting she was "heartbroken and worried".
She said on her website: "Singing is literally my life, its my hobby, my love, my freedom and now my job.
"I have absolutely no choice but to recuperate properly and fully, or I risk damaging my voice forever."
She added: "I follow all the advice I'm given and stick to regimes, rules and practices to the best of my ability but it seems to simply not be enough."
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