Introduction: The 10th Albanian Congress of Trauma and Emergency Surgery (ACTES 2026), held on 25–26 September 2026 in Tirana, Albania, brought together surgeons, anesthesiologists, intensivists, radiologists, nurses and allied professionals to share current evidence and clinical experience in the care of injured and acutely ill surgical patients. Aim: To provide a structured, citable record of the scientific work presented at ACTES 2026 and to make it accessible to the international trauma and emergency surgery community. Methods: All abstracts accepted for oral or poster presentation were included. They were edited for format only, organized in a structured IMRAD layout with keywords, and their references were unified in Vancouver style. Author names and affiliations were checked for consistency. Results: The supplement contains 248 abstracts by more than 420 authors from 15 countries, mainly Albania, Italy, Germany, England, Ireland, Canada, Romania, Cyprus, Austria, Switzerland, North Macedonia, Greece, Israel, Turkey, and Kosovo. Retrospective clinical studies form the largest group (about one third), followed by narrative reviews, case reports, prospective studies, and systematic reviews or meta-analyses. Trauma care accounts for about 40% of the abstracts. Other topics include emergency general surgery, orthopedic trauma, vascular and cardiac emergencies, critical care and anesthesia, burns and reconstructive surgery, pediatric and oncologic emergencies, and trauma systems, education and digital health. Conclusions: The ACTES 2026 abstracts reflect growing regional and international collaboration in trauma and emergency surgery and provide a reference point for future research, training, and quality improvements in Albania, the region, and beyond...
Background: Foreign body aspiration constitutes a serious and potentially life-threatening emergency in infants and children. Delayed diagnosis and treatment can result in severe respiratory complications and mortality. Aim: To evaluate the clinical characteristics, diagnostic approaches, treatments, and outcomes of children with foreign body aspiration managed over a 20-year period in Albania. Materials and Methods: A retrospective review was conducted of 149 children who underwent rigid bronchoscopy for suspected airway foreign body aspiration at the institution from 2006 to 2015, and 230 children from 2015 to 2024. Demographic data, clinical presentations, referral patterns, diagnostic procedures, complications, and outcomes were analyzed. Results: During 2006-2015, foreign bodies were removed from the larynx, trachea, or bronchial tree in 105 children. The mean age was 23 months, and 60% of patients were male. A choking episode was reported in 51% of cases, resulting in immediate referral to the ENT service, while 49% initially presented to the pediatric service with symptoms such as cough, pneumonia, or asthma. Flexible bronchoscopy was performed first in the latter group. The overall complication rate was 19%, including emphysema, atelectasis, pneumonia, bronchiectasis, pyopneumothorax, and pneumomediastinum. The false-positive rate was 20%. Complications related to flexible bronchoscopy, such as laryngeal edema, hypoxia, and bleeding, occurred in 6% of patients. One death occurred in a child who presented in hypoxic arrest… Conclusion: Foreign body aspiration in children remains a medical emergency that requires rapid recognition and prompt intervention with rigid bronchoscopy. Delayed diagnosis is associated with increased complication rates and poorer outcomes.
Background: The vertebral arteries are integral to the vertebrobasilar system, contributing approximately 20% of cerebral blood flow and ensuring perfusion of the posterior brain and spinal cord. Anatomical variations such as hypoplasia and dolichoectasia may compromise posterior circulation hemodynamics and influence cerebrovascular risk. Objective: To investigate the prevalence, diameter, and gender distribution of vertebral artery variations and assess their potential clinical implications for posterior cerebral circulation. Materials and Methods: A retrospective observational study was conducted on 60 patients (25 females, 41.7%; 35 males, 58.3%; mean age 45.0 ± 12.0 years). Radiological evaluation included Magnetic Resonance Angiography, Doppler ultrasonography, and Computed Tomography. Vertebral artery morphology was classified as normal, hypoplastic, or dolichoectatic. Results: Hypoplasia was the most frequent variation. In females, hypoplasia was observed in 28.0% of left and 40.0% of right vertebral arteries. In males, it was present in 20.0% of left and 22.9% of right arteries. Dolichoectasia was more prevalent in males. These findings highlight gender-related differences and underscore the importance of vascular imaging in patients with posterior circulation symptoms. Conclusion: Vertebral artery variations are relatively common and clinically significant. Recognition of these variations is essential for accurate diagnosis, risk stratification, and management of cerebrovascular disorders involving posterior circulation.
Introduction: Mediastinal pathologies comprise a heterogeneous group of congenital, neoplastic, infectious, inflammatory, traumatic, and iatrogenic conditions affecting one of the most anatomically complex regions of the thorax. Due to the proximity of vital structures, including the heart, great vessels, trachea, and esophagus, their diagnosis and management remain particularly challenging. Recent advances in computed tomography, magnetic resonance imaging, positron emission tomography, histopathological classification systems, minimally invasive biopsy techniques, and thoracoscopic surgery have significantly improved the management and prognosis of mediastinal diseases. This review summarizes contemporary concepts regarding mediastinal pathology, emphasizing anatomical classification, imaging characteristics, histopathological diagnosis, and surgical management. Major disease entities include thymic epithelial tumors, mediastinal neurogenic tumors, mesenchymal lesions, and rare mediastinal conditions. The review integrates recent international literature and current guidelines together with a single-center surgical experience reported in an institutional series, including thymoma associated with myasthenia gravis, thymic carcinoma, neurogenic tumors, mesenchymal tumors, hydatid disease, vascular trauma, and rare postoperative complications. Conclusion: Mediastinal diseases encompass a broad and heterogeneous spectrum of pathological entities requiring individualized diagnostic and therapeutic strategies. Advances in imaging, histopathology, minimally invasive biopsy techniques, and thoracic surgery have significantly improved patient outcomes
Background: Wunderlich syndrome is an uncommon but potentially fatal clinical entity defined by spontaneous, non-traumatic renal or perirenal hemorrhage. It is most frequently associated with renal angiomyolipoma, particularly in patients with tuberous sclerosis complex (TSC), where lesions are often bilateral, large, and highly vascularized, predisposing them to rupture. Case Presentation: We report the case of a 30-year-old female with a known history of TSC who presented to the emergency department with acute right flank pain and signs of hypovolemic shock. Contrast-enhanced computed tomography (CECT) revealed a large right-sided perirenal and retroperitoneal hematoma with active contrast extravasation, originating from a ruptured renal angiomyolipoma. Multiple bilateral renal angiomyolipomas were also identified. The prompt use of advanced imaging facilitated rapid diagnosis and guided urgent management. Discussion: This case underscores the pivotal role of CECT as the diagnostic modality of choice in suspected Wunderlich syndrome, allowing precise localization of bleeding, assessment of lesion characteristics, and evaluation of hemorrhage extent. Patients with TSC require close radiological surveillance due to the elevated risk of angiomyolipoma rupture and life-threatening hemorrhagic complications. Conclusion: Wunderlich syndrome represents a rare but critical urological emergency, particularly in patients with TSC. Early recognition through contrast-enhanced imaging is essential for timely intervention and improved clinical outcomes. Proactive monitoring of renal angiomyolipomas in high-risk populations is imperative to prevent catastrophic events.
