Upper and Lower Gastrointestinal System Endoscopy Indications

As endoscopic procedures have become widespread, they have largely replaced radiological methods in the diagnosis of gastrointestinal system diseases; because the accurate diagnosis rates of endoscopic procedures are very high compared to conventional radiological procedures. In addition, tissue and cell sample for histopathological studies It is also advantageous because it can be taken and some diseases can be treated endoscopically. Rigid endoscopes have been replaced by flexible endoscopes, making them widely used in both diagnosis and treatment. The increase in the use of endoscopy brings with it complications. Therefore, the indications for endoscopy should be clearly stated. Indications for endoscopic examination of the digestive system can be divided into three as diagnosis, follow-up and treatment

Sol diafram yaralanması tespiti nasıl yapılmalıdır?

Giriş: Travmatik diafram yaralanmaları künt ve delici aletle yaralanmalar sonrasında ortaya çıkan ve sıklıkla gözden kaçan bir sorun- dur. Biz çalışmamızda; kliniğimize sol torakoabdominal bölgeden olan yaralanma ile başvuran hastalar için uygulanan tanı yöntem- lerini karşılaştırdık. Metod: Kliniğimize sol delici kesici alet yaralanması ile konsulte edilen ve tetkik ve tedavisi yapılan 62 hasta ça- lışmaya dahil edildi. Hastalar akciğer grafisi, USG, tomografi ve laparoskopi yapılarak sonuçları incelendi. Sonuçlar: Hastaların 11’i inceleme dışı bırakıldı. Kalan 51 hastanın 26 tanesinde %50.98 diafram yaralanması mevcuttu 25 tanesinde %49.02 ise herhangi bir patoloji rastlanmadı. Tartışma: Sol torakoabdominal bölgeden olan delici kesici alet lezyonları sol tarafta diafram yaralanmasına sebep olması ve sağdaki gibi diafram karaciğer tarafından kapatılmadığından acil tanı almalı ve tedavi edilmelidir. Tanı için hastalara diagnostik laparaskopi yapılmalıdı

Infected pancreatic necrosis: outcomes and clinical predictors of mortality. A post hoc analysis of the MANCTRA-1 international study

: The identification of high-risk patients in the early stages of infected pancreatic necrosis (IPN) is critical, because it could help the clinicians to adopt more effective management strategies. We conducted a post hoc analysis of the MANCTRA-1 international study to assess the association between clinical risk factors and mortality among adult patients with IPN. Univariable and multivariable logistic regression models were used to identify prognostic factors of mortality. We identified 247 consecutive patients with IPN hospitalised between January 2019 and December 2020. History of uncontrolled arterial hypertension (p = 0.032; 95% CI 1.135-15.882; aOR 4.245), qSOFA (p = 0.005; 95% CI 1.359-5.879; aOR 2.828), renal failure (p = 0.022; 95% CI 1.138-5.442; aOR 2.489), and haemodynamic failure (p = 0.018; 95% CI 1.184-5.978; aOR 2.661), were identified as independent predictors of mortality in IPN patients. Cholangitis (p = 0.003; 95% CI 1.598-9.930; aOR 3.983), abdominal compartment syndrome (p = 0.032; 95% CI 1.090-6.967; aOR 2.735), and gastrointestinal/intra-abdominal bleeding (p = 0.009; 95% CI 1.286-5.712; aOR 2.710) were independently associated with the risk of mortality. Upfront open surgical necrosectomy was strongly associated with the risk of mortality (p < 0.001; 95% CI 1.912-7.442; aOR 3.772), whereas endoscopic drainage of pancreatic necrosis (p = 0.018; 95% CI 0.138-0.834; aOR 0.339) and enteral nutrition (p = 0.003; 95% CI 0.143-0.716; aOR 0.320) were found as protective factors. Organ failure, acute cholangitis, and upfront open surgical necrosectomy were the most significant predictors of mortality. Our study confirmed that, even in a subgroup of particularly ill patients such as those with IPN, upfront open surgery should be avoided as much as possible. Study protocol registered in ClinicalTrials.Gov (I.D. Number NCT04747990)

To investigate possible etiologic factors of organic and functional dyspepsia in Turkey

Objective: Dyspepsia can be defined as a combination of unspecific symptoms with gastrointestinal origin and patients with dyspepsia reveal pathologies associated with dyspepsia called organic dyspepsia; if no local or systemic disease can be found as the cause called functional dyspepsia. In this article we aimed to investigate possible etiologic factors and prevalance of organic and functional dyspepsia in Turkey

Clinical significance of serum omentin-1 levels in patients with pancreatic adenocarcinoma

Background: Omentin is related with metabolic syndrome and obesity. Pancreatic adenocarcinoma (PA) is a lethal and obesity-linked malignancy. This study was conducted to investigate the serum levels of omentin in patients with PA and the relationship with tumor progression and known prognostic parameters

Clinical significance of serum omentin-1 levels in patients with pancreatic adenocarcinoma

Background: Omentin is related with metabolic syndrome and obesity. Pancreatic adenocarcinoma (PA) is a lethal and obesity-linked malignancy. This study was conducted to investigate the serum levels of omentin in patients with PA and the relationship with tumor progression and known prognostic parameters. Material and methods: Serum samples were obtained from thirty-three patients on first admission before any treatment. Age, sex and body mass index (BMI) matched 30 healthy controls were included in the analysis. Both serum omentin levels were measured using enzyme-linked immunosorbent assay (ELISA). Results: The median age at diagnosis was 59 years (32–84 years). Twenty (61%) patients were men and the remaining were women. The most common metastatic site was liver in 23 patients with metastasis (n = 19, 83%). Thirty-nine percent of 23 metastatic patients who received palliative chemotherapy (CTx) were CTx–responsive. Median overall survival of the whole group was 41.3 ± 8.3 weeks [95% confidence interval (CI) = 25–58 weeks]. The baseline serum omentin levels were significantly higher in patients with PA than in the control group (p < 0.001). Serum omentin levels were significantly higher in patients with larger pathologic tumor size compared with smaller size (p = 0.03). Conversely, serum omentin concentration was found to have no prognostic role on survival (p = 0.54). Conclusion: Serum levels of omentin may have a good diagnostic role in patients with PA

Intramural hematomas of the gastrointestinal system: a 5-year single center experience

Purpose: Although spontaneous intramural hematomas of the gastrointestinal tract are very rare, they may be observed with the use of oral anticoagulant, though less frequently in cases of hematological malignancy and other bleeding disorders. Cases diagnosed as spontaneous intramural hematoma have been assessed in our clinic

Predictive Value of Presepsin in Determining Leaks After Laparoscopic Sleeve Gastrectomy: A Pilot Study

Objectives: Laparoscopic sleeve gastrectomy (LSG) is among the most effective surgical interventions in the long-term prevention of morbid obesity. Stapler line leaks and stapler line bleedings are important complications, which affect morbidity and mortality. The aim of this study is to determine the role of plasma presepsin levels for detection of stapler leaks