3 articles
Dysphagia lusoria refers to dysphagia caused by an aberrant right subclavian artery (ARSA), a rare congenital anomaly of the aortic arch. This article presents a clinical case of symptomatic ARSA, accompanied by a comprehensive review of its anatomical, clinical, and therapeutic aspects.
We present the case of a 54-year-old female patient diagnosed with dysphagia lusoria due to ARSA, who underwent surgical intervention after clinical and imaging evaluations. The literature was reviewed through PubMed using the keywords: “aberrant right subclavian artery”, “dysphagia lusoria”, and “arteria lusoria”.
The patient presented with progressive dysphagia, morning cough, fatigue, and weight loss. Imaging revealed ARSA compressing the esophagus, and the presence of a bicarotid trunk. Surgical correction involved right subclavian-to-carotid transposition, with complete resolution of symptoms. The literature review showed a modest grade of evidence regarding the management of patients with dysphagia lusoria, mostly including case reports and limited case series. Treatment is usually indicated in symptomatic patients, with options including open surgery or hybrid approaches.
ARSA can cause significant esophageal symptoms in adults, representing a diagnostic challenge. Appropriate imaging and timely surgical intervention are crucial in symptomatic cases. Awareness of aortic anatomical variants is essential for both diagnosis and treatment planning.
Lung cancer exhibits high global incidence and mortality rates. Surgical resection remains crucial to diagnosis, staging, and treatment of non-small cell lung cancer (NSCLC). However, advanced stages often require multimodal approaches. Prehabilitation, innovative perioperative techniques, and the exploration of immunotherapy hold promise for improving outcomes.
This two-phase observational cohort study included a retrospective arm (100 patients, traditional treatment) and a prospective arm (100 patients, innovative perioperative management, and risk stratification). Descriptive and inferential statistics were used to evaluate data, identify risk factors, and compare the 2-year survival between treatment groups.
Despite advances, lung cancer prognosis remains poor, with limited cure rates. Mean survival in the traditional approach was 1.3 years with a 5-year survival of only 1%. While prehabilitation and innovative techniques showed potential, no statistically significant differences in survival times were observed between the treatment groups. Patients with stage III (Charlson score 0-4) and stage I-II (Charlson score 5-12) demonstrated comparable outcomes, highlighting the importance of comorbidity burden.
Targeted screening protocols are of paramount importance for early detection and intervention. Population-wide smoking cessation programs, environmental protection measures, and the promotion of healthy lifestyles are vital for prevention and reducing incidence. Standard chemotherapy and radiotherapy offer limited therapeutic benefits in advanced lung cancer. This highlights a pressing need for breakthroughs in basic research to develop novel treatment paradigms that significantly improve outcomes. While this study did not reveal statistically significant survival differences between traditional and innovative perioperative approaches, prehabilitation and optimization techniques hold promise and deserve further research. The development of anti-tumor immunotherapy offers a significant potential in non-surgical lung cancer treatment, especially given the limitations in advanced-stage disease management. Harnessing the immune system to fight cancer represents a promising new frontier.
The unintentional leaving of gauze sponges in the abdomen after laparotomy is a rare but serious medical error. The diagnosis of a textile foreign body can be challenging due to its rarity, potential long-term asymptomatic evolution, and nonspecific imaging findings that may be unfamiliar to radiologists.
The data of 13 radiologically identified and surgically confirmed cases of abdominal textilomas treated over a 15-year period were assessed retrospectively. There were 10 women (76.9%) and 3 men (23.1%); the average age was 38.5±4.7 years. The average interval between the previous procedure and the diagnosis of textiloma was 25.3±15.2 months, ranging from 1 day to 16 years.
The most common imaging patterns seen on CT included masses with a typical spongiform structure with numerous small air bubbles and surrounded by a thin capsule, as well as a high-density, well-circumscribed lesion, sometimes with mottled calcification, and a dense capsule with intense contrast accumulation. Based on surgical history, physical examination, and CT scan findings, a likely diagnosis of textiloma was made before surgery in 11 (84.6%). In all patients, a repeated open surgery was necessary to remove textile foreign bodies.
The possibility of an abdominal textiloma should be considered in the differential diagnosis of any postoperative patient who presents with pain, infection, or a palpable mass. CT scanning is a practical and highly sensitive diagnostic tool for detecting textilomas with characteristic imaging features in both chronic encapsulated and acute inflammatory manifestations.