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Atarere J, Naqvi H, Haas C, Adewunmi C, Bandaru S, Allamneni R, Ugonabo O, Egbo O, Umoren M, Kanth P. Applicability of Online Chat-Based Artificial Intelligence Models to Colorectal Cancer Screening. Dig Dis Sci 2024; 69:791-797. [PMID: 38267726 DOI: 10.1007/s10620-024-08274-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2023] [Accepted: 01/02/2024] [Indexed: 01/26/2024]
Abstract
BACKGROUND Over the past year, studies have shown potential in the applicability of ChatGPT in various medical specialties including cardiology and oncology. However, the application of ChatGPT and other online chat-based AI models to patient education and patient-physician communication on colorectal cancer screening has not been critically evaluated which is what we aimed to do in this study. METHODS We posed 15 questions on important colorectal cancer screening concepts and 5 common questions asked by patients to the 3 most commonly used freely available artificial intelligence (AI) models. The responses provided by the AI models were graded for appropriateness and reliability using American College of Gastroenterology guidelines. The responses to each question provided by an AI model were graded as reliably appropriate (RA), reliably inappropriate (RI) and unreliable. Grader assessments were validated by the joint probability of agreement for two raters. RESULTS ChatGPT and YouChat™ provided RA responses to the questions posed more often than BingChat. There were two questions that > 1 AI model provided unreliable responses to. ChatGPT did not provide references. BingChat misinterpreted some of the information it referenced. The age of CRC screening provided by YouChat™ was not consistently up-to-date. Inter-rater reliability for 2 raters was 89.2%. CONCLUSION Most responses provided by AI models on CRC screening were appropriate. Some limitations exist in their ability to correctly interpret medical literature and provide updated information in answering queries. Patients should consult their physicians for context on the recommendations made by these AI models.
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Affiliation(s)
- Joseph Atarere
- Department of Medicine, MedStar Health, 201 East University Pkwy, Baltimore, MD, 21218, USA.
- Department of Biostatistics and Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA.
| | - Haider Naqvi
- Department of Medicine, MedStar Health, 201 East University Pkwy, Baltimore, MD, 21218, USA
| | - Christopher Haas
- Department of Medicine, MedStar Health, 201 East University Pkwy, Baltimore, MD, 21218, USA
| | - Comfort Adewunmi
- Division of Geriatrics and Gerontology, Emory University School of Medicine, Atlanta, GA, USA
| | - Sumanth Bandaru
- Department of Medicine, MedStar Health, 201 East University Pkwy, Baltimore, MD, 21218, USA
| | - Rakesh Allamneni
- Department of Medicine, MedStar Health, 201 East University Pkwy, Baltimore, MD, 21218, USA
| | - Onyinye Ugonabo
- Department of Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Olachi Egbo
- Department of Medicine, Aurora Medical Center, Oshkosh, WI, USA
| | - Mfoniso Umoren
- Division of Gastroenterology, Georgetown University Hospital, Washington, DC, USA
| | - Priyanka Kanth
- Division of Gastroenterology, Georgetown University Hospital, Washington, DC, USA
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Ugonabo O, Malik SU, Akbar UA, Zamani Z, Frandah W. Physician-scientists or celebrities? Kardashian-index of gastroenterologists. World J Methodol 2023; 13:337-344. [PMID: 37771873 PMCID: PMC10523252 DOI: 10.5662/wjm.v13.i4.337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 07/18/2023] [Accepted: 08/29/2023] [Indexed: 09/20/2023] Open
Abstract
BACKGROUND The coronavirus disease 2019 pandemic unleashed a flood of untrustworthy information on social media platforms, resulting in the unfortunate consequence of expert scientists' opinions getting lost amidst the chaotic sea of misinformation. The question of how much influence these esteemed scientists hold on social media platforms remains elusive. To address this scientific quandary, we sought to explore the concept of the Kardashian index (K-index), a term introduced by Hall in 2014. This metric provides a rudimentary means of evaluating whether a physician scientist's popularity on social media aligns with their significant scientific contributions. AIM To evaluate if a Gastroenterologist physician's popularity on social media is at par with their scientific contributions (research articles and publications). METHODS We conducted an extensive search to identify all gastroenterologists actively practicing and associated with the top 100 hospitals as reported by the United States News. We collected specific data on a sub-group including their names, affiliations, degrees, and sub-specializations. To gauge their social media popularity, we utilized the K-index calculation which is determined by dividing the actual number of Twitter followers by the number of researcher's citations. The expected number of followers (F) is calculated using the formula F = 43.3 C ^ 0.32, where C represents the number of citations. RESULTS Physicians affiliated with the Mayo Clinic emerged as the most prominent presence on Twitter, constituting 16% of the total. They were followed closely by physicians from Mount Sinai Hospital (9%) and the University of Michigan Hospital (9%). Surprisingly, 76% of the physicians evaluated exhibited a low K-index, falling within the range of 0 to less than 2. This suggests that a significant number of highly influential physician-scientists are not receiving due recognition, as indicated by their relatively low number of followers. On the other hand, 24% of the physicians had an inflated K-index, exceeding 5, which positioned them as the "Kardashians". These individuals enjoyed greater social media popularity than their actual scientific contributions. Interestingly, our analysis revealed no discernible association between sex and K-index (P value of 0.92). CONCLUSION In the gastroenterology field, our study estimated that a majority (76%) of highly researched physicians are undervalued despite their significant scientific contributions.
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Affiliation(s)
- Onyinye Ugonabo
- Department of Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, WV 25701, United States
| | - Saad Ullah Malik
- Department of Cardiology, Geisinger Medical Center, Danville, PA 17821, United States
| | - Usman Ali Akbar
- Department of Internal Medicine, West Virginia University-Camden Clark Medical Center, Parkersburg, WV 26101, United States
| | - Zarlakhta Zamani
- Department of Internal Medicine, Centinela Hospital Medical Center, Inglewood, CA 90301, United States
| | - Wesam Frandah
- Department of Gastroenterology, Marshall University Joan C. Edwards School of Medicine, Huntington, WV 25701, United States
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Ugonabo O, Udoh UAS, Rajan PK, Reeves H, Arcand C, Nakafuku Y, Joshi T, Finley R, Pierre SV, Sanabria JR. The Current Status of the Liver Liquid Biopsy in MASH Related HCC: Overview and Future Directions. Biomolecules 2023; 13:1369. [PMID: 37759769 PMCID: PMC10526956 DOI: 10.3390/biom13091369] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Revised: 09/03/2023] [Accepted: 09/07/2023] [Indexed: 09/29/2023] Open
Abstract
Metabolic dysfunction-associated steatohepatitis (MASH) is one of the major risk factors for chronic liver disease and hepatocellular carcinoma (HCC). The incidence of MASH in Western countries continues to rise, driving HCC as the third cause of cancer-related death worldwide. HCC has become a major global health challenge, partly from the obesity epidemic promoting metabolic cellular disturbances but also from the paucity of biomarkers for its early detection. Over 50% of HCC cases are clinically present at a late stage, where curative measures are no longer beneficial. Currently, there is a paucity of both specific and sensitive biological markers for the early-stage detection of HCC. The search for biological markers in the diagnosis of early HCC in high-risk populations is intense. We described the potential role of surrogates for a liver biopsy in the screening and monitoring of patients at risk for nesting HCC.
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Affiliation(s)
- Onyinye Ugonabo
- Department of Medicine, Marshall University School of Medicine, Marshall University, Huntington, WV 25701, USA; (O.U.); (T.J.)
| | - Utibe-Abasi Sunday Udoh
- Marshall Institute for Interdisciplinary Research, Marshall University School of Medicine, Huntington, WV 25703, USA; (U.-A.S.U.); (P.K.R.); (Y.N.); (S.V.P.)
- Department of Surgery, Marshall University School of Medicine, Marshall University, Huntington, WV 25701, USA; (H.R.); (C.A.); (R.F.)
| | - Pradeep Kumar Rajan
- Marshall Institute for Interdisciplinary Research, Marshall University School of Medicine, Huntington, WV 25703, USA; (U.-A.S.U.); (P.K.R.); (Y.N.); (S.V.P.)
- Department of Surgery, Marshall University School of Medicine, Marshall University, Huntington, WV 25701, USA; (H.R.); (C.A.); (R.F.)
| | - Heather Reeves
- Department of Surgery, Marshall University School of Medicine, Marshall University, Huntington, WV 25701, USA; (H.R.); (C.A.); (R.F.)
| | - Christina Arcand
- Department of Surgery, Marshall University School of Medicine, Marshall University, Huntington, WV 25701, USA; (H.R.); (C.A.); (R.F.)
| | - Yuto Nakafuku
- Marshall Institute for Interdisciplinary Research, Marshall University School of Medicine, Huntington, WV 25703, USA; (U.-A.S.U.); (P.K.R.); (Y.N.); (S.V.P.)
- Department of Surgery, Marshall University School of Medicine, Marshall University, Huntington, WV 25701, USA; (H.R.); (C.A.); (R.F.)
| | - Tejas Joshi
- Department of Medicine, Marshall University School of Medicine, Marshall University, Huntington, WV 25701, USA; (O.U.); (T.J.)
| | - Rob Finley
- Department of Surgery, Marshall University School of Medicine, Marshall University, Huntington, WV 25701, USA; (H.R.); (C.A.); (R.F.)
| | - Sandrine V. Pierre
- Marshall Institute for Interdisciplinary Research, Marshall University School of Medicine, Huntington, WV 25703, USA; (U.-A.S.U.); (P.K.R.); (Y.N.); (S.V.P.)
| | - Juan Ramon Sanabria
- Marshall Institute for Interdisciplinary Research, Marshall University School of Medicine, Huntington, WV 25703, USA; (U.-A.S.U.); (P.K.R.); (Y.N.); (S.V.P.)
- Department of Surgery, Marshall University School of Medicine, Marshall University, Huntington, WV 25701, USA; (H.R.); (C.A.); (R.F.)
- Department of Nutrition and Metabolomic Core Facility, Case Western Reserve University School of Medicine, Cleveland, OH 44106, USA
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Ugonabo O, Turki M, Stewart D, Sherif A, Villa X. A Masking Effect: A Case of Initial Presentation of Ulcerative Colitis After Discontinuing Growth Hormone Therapy. Crohns Colitis 360 2023; 5:otad041. [PMID: 37636009 PMCID: PMC10460195 DOI: 10.1093/crocol/otad041] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Indexed: 08/29/2023] Open
Abstract
Background The inflammation and repair of the intestinal mucosa in inflammatory bowel disease (IBD) involve a complex interplay between innate, adaptive immune responses, and hormones. This may explain the relapsing clinical course of the disease. Methods We present the first reported case of a patient presenting their initial flare of ulcerative colitis immediately after discontinuing growth hormone (GH) therapy, suggesting treatment with GH or growth factors may prevent the development of IBD. Results This is a case of a 13-year-old female with a history of GH deficiency, presenting with an 8-week history of abdominal pain, blood-stained diarrhea, and fecal calprotectin greater than 8000 mcg/g, 2 weeks after discontinuing GH therapy. The patient subsequently underwent an esophagoduodenoscopy and colonoscopy with biopsies showing histological features consistent with ulcerative colitis. Conclusions The finding of withdrawing GH or growth factors therapy potentially unmasking IBD in this patient raises a question of whether growth factors can inhibit the development of IBD and suggests beneficial effects of treatment with GH or growth factors as adjuvant therapy for IBD.
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Affiliation(s)
- Onyinye Ugonabo
- Department of Internal Medicine, Marshall University, Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - M'hamed Turki
- Division of Gastroenterology, Marshall University, Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Dane Stewart
- Department of Internal Medicine, Marshall University, Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Ahmed Sherif
- Division of Gastroenterology, Marshall University, Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Xavier Villa
- Department of Pediatrics, Division of Pediatric Gastroenterology, Marshall University, Joan C. Edwards School of Medicine, Huntington, WV, USA
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Ugonabo O, Chudy-Onwugaje K. Autoimmune Hepatitis Disguised as Iron Overload Syndrome: Diagnostic Dilemma in a Nigerian Man. J Investig Med High Impact Case Rep 2023; 11:23247096231175442. [PMID: 37203348 DOI: 10.1177/23247096231175442] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Autoimmune hepatitis (AIH) is an extremely rare cause of chronic liver disease (CLD) in sub-Saharan Africa-there have only been 3 reported cases of AIH in Nigeria, a country of about 200 million people. We report the first case of AIH in a male patient in Nigeria and highlight its unusual presentation. A 41-year-old man with jaundice and malaise for 3 months was referred for evaluation after investigations revealed deranged liver enzymes and a cirrhotic liver. Laboratory evaluation revealed high serum immunoglobulin G, but there was also marked elevation of serum ferritin and transferrin saturation, resulting in a diagnostic dilemma between AIH and an iron overload condition such as hemochromatosis. A liver biopsy was crucial in providing a definitive diagnosis of AIH. Despite its rarity, clinicians should maintain a high index of suspicion for AIH in sub-Saharan Africa and should proceed to a liver biopsy when the cause of CLD is unclear.
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Affiliation(s)
| | - Kenechukwu Chudy-Onwugaje
- Memorial Hospital Belleville, IL, USA
- Eurocare Multispecialty Hospital, Lagos, Nigeria
- University of Pennsylvania, Philadelphia, USA
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Perdoncin M, Ezeh E, Ugonabo O, Robertson R, Gilkerson C. A Busted Sac: A Case of Spontaneous Bladder Rupture Secondary to Acute Urinary Retention in a Healthy Middle-Aged Male. J Investig Med High Impact Case Rep 2023; 11:23247096221148262. [PMID: 36705092 PMCID: PMC9903008 DOI: 10.1177/23247096221148262] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
Spontaneous bladder rupture is a relatively rare medical emergency that can be easily misdiagnosed. Although spontaneous bladder rupture is more common in those with previously diagnosed bladder conditions, this phenomenon may also occur in patients with an otherwise insignificant past medical history. Early diagnosis and treatment are critical to avoid fatal complications. Here, we present a 49-year-old male with insignificant past medical history who was diagnosed with spontaneous bladder rupture after the attempted placement of a Foley catheter.
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Affiliation(s)
- Maddie Perdoncin
- Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Ebubechukwu Ezeh
- Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USA
| | - Onyinye Ugonabo
- Marshall University Joan C. Edwards School of Medicine, Huntington, WV, USA
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Ugonabo O, Mohamed T, Kheetan M, Sherif A. Failure to Thrive in a Middle-Aged Female: A Case of Congenital Incomplete Pancreas From a Rare Genetic Defect. J Investig Med High Impact Case Rep 2023; 11:23247096231165742. [PMID: 37052076 PMCID: PMC10102923 DOI: 10.1177/23247096231165742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/14/2023] Open
Abstract
Hepatocyte nuclear factor-1 beta (HNF1B) gene is predominantly expressed in the liver, kidney, lung, genitourinary tract, and pancreas. It is an important transcription factor that regulates pancreas development. Mutation or absence of this gene is rare and can cause incomplete pancreatic development known as the agenesis of the dorsal pancreas. This rare genetic abnormality is associated with other disorders like maturity-onset diabetes of the young, abnormal liver function tests, genitourinary tract malformation, pancreatitis, and renal cysts. Diagnosing this genetic abnormality is difficult, especially in patients presenting with symptoms specific to only one system. Management is based on disease manifestation and involves a multidisciplinary approach. Our case describes a 51-year-old female with poorly controlled diabetes mellitus and Mullerian duct anomalies who presented with abdominal pain, fatigue, dizziness, and electrolyte derangement. Contrast-enhanced computed tomography (CECT) of the abdomen showed a multicystic kidney and a pancreatic head with a missing body and tail. Further workup revealed an HNF1B mutation.
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8
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Ugonabo O, Pulipati Y, Elghezewi A, Miller V, Logan L, Pramod P. An Unusual Case of Hepatocellular Carcinoma in a Healthy Teenager. J Investig Med High Impact Case Rep 2023; 11:23247096231165744. [PMID: 37119001 PMCID: PMC10155027 DOI: 10.1177/23247096231165744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/30/2023] Open
Abstract
Hepatocellular carcinoma (HCC) is a primary liver malignancy known to occur majorly in patients with liver cirrhosis or those with a harbinger of risk factors like viral hepatitis, autoimmune liver disease, alpha-1 antitrypsin deficiency, alcoholic liver disease, and nonalcoholic fatty liver disease. The incidence of HCC has risen in the past 2 decades and currently ranks as the sixth most common cause of cancer-related death worldwide. Most cases are seen in adulthood, and only a very small percentage have been reported in adolescents with risk factors. The 2 pathologic subtypes of pediatric HCC are classic and fibrolamellar. Here, we discussed a very interesting rare case of a healthy male teenager with no apparent liver disease or risk factor who presented with right-upper-quadrant pain, normal alpha-fetoprotein level, and abdominal ultrasound showing a large hepatic mass. A liver biopsy was positive for HCC with fluorescent in situ hybridization showing a PRKACA complex gene pattern, favoring the fibrolamellar type.
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Ugonabo O, Mohamed M, Ezeh E, Simmons J, Cuda J, Ghavimi S. A Rare Metastatic Primary Rectal Melanoma in a Geriatric Male. J Med Cases 2022; 13:369-373. [PMID: 36128069 PMCID: PMC9451565 DOI: 10.14740/jmc3929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2022] [Accepted: 07/14/2022] [Indexed: 11/11/2022] Open
Abstract
Primary rectal melanoma (PRM) is an uncommon malignancy whose etiology remains unknown. Most patients present with rectal bleeding. Distant metastasis is commonly seen in the lung and liver. The incidence rates for locoregional lymph node metastases on initial presentation are almost 60%. Histology and immunochemistry are useful and are the gold standard for diagnosis. The prognosis is very poor due to the late presentation of patients. Optimum surgical treatment remains controversial. Abdominoperineal resection was considered traditionally but over time, has been found to have no survival benefit. Current literature and studies, therefore, recommend wide local excision. The beneficial effects of chemotherapy versus radiotherapy use are still debatable. Herein, we discuss a case of a 72-year-old Caucasian male with rectal bleeding found to have metastasized PRM.
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Affiliation(s)
- Onyinye Ugonabo
- Department of Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, WV 25701, USA
- Corresponding Author: Onyinye Ugonabo, Internal Medicine Residency Program, Marshall University Joan C. Edwards School of Medicine, Huntington, WV 25701, USA.
| | - Mujtaba Mohamed
- Department of Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, WV 25701, USA
| | - Ebubechukwu Ezeh
- Department of Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, WV 25701, USA
| | - Joseph Simmons
- Department of Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, WV 25701, USA
| | - Jonathan Cuda
- Department of Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, WV 25701, USA
| | - Shima Ghavimi
- Department of Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, WV 25701, USA
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10
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Ugonabo O, Mohamed M, Frandah W, Sherif A. Two Patients With Difficulty in Swallowing due to Dysphagia Lusoria. J Med Cases 2022; 13:313-317. [PMID: 35949941 PMCID: PMC9332825 DOI: 10.14740/jmc3930] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2022] [Accepted: 05/28/2022] [Indexed: 11/26/2022] Open
Abstract
Dysphagia lusoria (DL) is a rare clinical entity caused by compression of the esophagus by an aberrant right subclavian artery. It is coined from the Latin word meaning freak or jest of nature, with an estimated prevalence of approximately 0.5%. Before the term DL was known, the artery abnormality was referred to as luxus nature. Most patients are asymptomatic. In 30-40% of cases, DL results in tracheoesophageal symptoms like dysphagia to solid foods, chest pain, cough, and Horner’s syndrome. Symptoms presenting later in life have been linked to arteriosclerosis and diminishing esophageal compliance resulting in compression. Another reason why people become symptomatic is due to Kommerell’s diverticulum, a disorder that was first described by Kommerell, a German radiologist in 1936. It is also known as lusoria diverticulum, remnant diverticulum or lusoria root. This disorder represents a remnant of the left dorsal arch which forms a vascular ring behind the esophagus, leading to external compression. The key to diagnosis of DL is a barium esophagogram which may show extrinsic compression. Computed tomography or magnetic resonance imaging can be used for definite delineation of the vascular anatomy. Treatment approach is dietary modification or surgical intervention for unresponsive cases. Here, we present cases of dysphagia in two middle-aged women caused by compression effect on the esophagus by an aberrant right subclavian artery who did not respond to dietary modification.
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Affiliation(s)
- Onyinye Ugonabo
- Division of Gastroenterology, Department of Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, USA
- Corresponding Author: Onyinye Ugonabo, Internal Medicine Residency Program, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, USA.
| | - Mujtaba Mohamed
- Division of Gastroenterology, Department of Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, USA
| | - Wesam Frandah
- Division of Gastroenterology, Department of Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, USA
| | - Ahmed Sherif
- Division of Gastroenterology, Department of Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV 25701, USA
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Ezeh E, Akhigbe EJ, Olubowale O, Ugonabo O, Hamilton M, Dao B, Mader J. The Destabilized Artery: A Case of Spontaneous Coronary Artery Dissection Presenting as Unstable Angina. Cureus 2021; 13:e20705. [PMID: 35106242 PMCID: PMC8788919 DOI: 10.7759/cureus.20705] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2021] [Indexed: 11/05/2022] Open
Abstract
Spontaneous coronary artery dissection (SCAD) is increasingly being recognized as a cause of acute coronary syndrome (ACS). This increased recognition of SCAD has been noted in patients with and without traditional cardiovascular risk factors such as diabetes mellitus, hyperlipidemia, and cigarette smoking. The increasing incidence is believed to be due to recent advances in diagnostic and coronary imaging modalities. The most common presenting feature is chest pain or discomfort. Normal troponin level does not rule out SCAD as the definitive diagnosis is made on coronary angiography. Percutaneous intervention (PCI) for SCAD has been associated with lower success rates compared to PCI for atherosclerotic coronary artery disease. Medical management is, therefore, the initial treatment of choice.
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Affiliation(s)
- Ebubechukwu Ezeh
- Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, USA
| | - Esiemoghie J Akhigbe
- Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, USA
| | - Olusola Olubowale
- Cardiology, Marshall University Joan C. Edwards School of Medicine, Huntington, USA
| | - Onyinye Ugonabo
- Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, USA
| | - Mackenzie Hamilton
- Internal Medicine, Marshall University Joan C. Edwards School of Medicine, Huntington, USA
| | - Benjamin Dao
- Cardiology, Marshall University Joan C. Edwards School of Medicine, Huntington, USA
| | - Jason Mader
- Cardiology, Marshall University, Huntington, USA
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