Purpose: Intestinal ischemia in strangulated abdominal wall hernias is a life-threatening condition that requires early detection and timely intervention. Since both systemic inflammation and nutritional status play a crucial role in surgical outcomes, identifying reliable predictive markers is essential. This study explores the potential of albumin-based nutritional indices—the CALLY Index, Prognostic Nutritional Index (PNI), and modified Glasgow Prognostic Score (mGPS)—to assess their ability to predict the risk of intestinal ischemia and the need for surgical resection. Methods: We retrospectively analyzed 125 patients who underwent surgery for incarcerated abdominal hernias between January 2015 and August 2024. Patients were categorized based on whether they had intestinal or omental ischemia. Key demographic data, perioperative findings, and laboratory parameters—including CRP, albumin, lymphocyte count, PNI, CALLY, and mGPS—were recorded. We performed univariate and multivariate regression analyses to identify independent risk factors, while ROC analysis was used to determine the optimal cutoff value for the CALLY Index. Results: Out of 125 patients, 66 (52.8%) were female, and the median age was 67 (58–76) years. Intestinal ischemia was found in 73 (58.4%) of the patients, while 23 (18.4%) had only omental necrosis. In the multivariate regression analysis, GPS 2 (OR: 19.299, p = 0.015) and CALLY < 2.5 (OR: 5.397, p = 0.017) were identified as independent predictors of intestinal ischemia. ROC analysis showed that a CALLY value below 2.5 had strong predictive power (AUC: 0.828, 95% CI: 0.753–0.902, p < 0.001). Conclusion: Our findings suggest that the CALLY Index and mGPS are valuable tools for predicting intestinal ischemia in strangulated abdominal hernias. By incorporating inflammatory and nutritional markers into risk assessment, these indices can assist in early diagnosis and timely surgical decision-making.

Purpose: The aim of the study is to demonstrate the prognostic impact of preoperative nutritional status indicators, including prognostic nutritional index (PNI), hemoglobin-albumin-lymphocyte-platelet (HALP) score, sarcopenia index (SI), and bone mineral density (BMD) values, on postoperative complications and survival in patients with resectable pancreatic cancer (PC). Materials and methods: The medical data and computed tomography (CT) images of 85 patients who undergone surgery for PC between January 2017 and 2023 were evaluated retrospectively. Patients were grouped according to the presence or absence of sarcopenia and osteoporosis, high and low PNI and HALP scores. The groups were compared in terms of the complication development rate, 30- and 90-day mortality, and 5-years overall survival (OS). Sarcopenia and osteoporosis were determined from CT images (sarcopenia index used for sarcopenia, bone mineral density for osteoporosis). Results: Except from OS (p < 0.0001), no differences were found between sarcopenic and non-sarcopenic groups in terms of postoperative complications, 30- and 90-day mortality (p = 0.775, p = 0.704, p = 0.196, respectively). There were no differences between the groups with and without osteoporosis in terms of the presence of postoperative complications, 30- and 90-day mortality, and OS (p = 0.770, p = 0.608, p = 0.196, p = 0.09, respectively) as low and high HALP score groups (p = 0.236, p = 0.696, p = 0.299, p = 0.45, respectively). Except from a 30-day mortality (p = 0.03), no differences were found between low and high PNI groups in terms of postoperative complications, 90-day mortality, and OS (p = 0.82, p = 0.09, p = 0.18, respectively). Conclusion: PNI may be used as prognostic data for early postoperative mortality, while sarcopenia may be indicative of 5-year OS in patients with resectable PC. Our results suggest that providing nutritional support may potentially improve prognosis. Future studies, in which other factors effective in prognosis are evaluated together with nutritional status, will show more information on this subject.

Background and Objectives: The best way to distinguish complicated acute appendicitis (CAA) from uncomplicated acute appendicitis (UCAA) is still under debate. The aim of this study was to investigate the potential use of the serum sodium (Na⁺) level and the neutrophil-to-lymphocyte ratio (NLR) to distinguish CAA from UCAA and to evaluate whether CAA is more reliably diagnosed using these two variables together. Materials and Methods: This was a retrospective, cross-sectional, two-center study of patients diagnosed with AA between 1 January 2016 and 31 December 2023. The demographic and analytical variables were analyzed. The NLR was defined as the quotient between the absolute values of neutrophils and lymphocytes. Hyponatremia was defined as a serum Na⁺ level of ≤135 mmol/L. The sensitivity and specificity of the NLR and the serum Na⁺ level in the diagnosis of CAA were determined by assessing the receiver operating characteristic curves. Results: Among the patients who underwent an appendectomy, 3066 histologically confirmed AA cases were identified and included in this study. The registered data revealed that 348 (11.3%) patients had CAA, and the remaining 2718 (88.7%) patients had UCAA. The mean ages were 49.47 ± 18.97 and 38.16 ± 14.50, respectively (p < 0.001). The analysis revealed an exponential correlation between the NLR and the serum Na⁺ level with a moderate degree of agreement with CAA (Cohen’s Kappa: 0.461, p < 0.001). For CAA, using the NLR and the serum Na⁺ level, the areas under the curve and the cutoffs were 0.664, 4.2 with a confidence interval (CI) of 0.647–0.681 and 0.727, 135 mmol/L with a CI of 0.711–0.742, respectively; all these values were significant with a p-value of <0.001. Conclusions: Although the serum Na⁺ level is a more effective marker than the NLR, using these two variables together can help detect high-risk patients who may benefit from early management by limiting delays in surgery.

Inflammatory pseudotumor (IPT) is a rare liver disease confused with liver tumors. It is a disease that should be known in the differential diagnosis for clinicians as the correct diagnosis of IPT will prevent unnecessary surgery. Demographic datas, diagnoses and imaging modalities of six patients with radiologically and/or histopathologically diagnosed hepatic IPT between 2016 and 2023 were retrospectively analyzed. Four out of six patients were female and median age was 57.5 (47-66). C-reactive protein was higher in four patients, and carbohydrate antigen 19.9 level was higher in one patient. We used magnetic resonance imaging (MRI) for diagnosis in five patients. Only in one patient computed tomography was enough for diagnosis. Tumor locations were segment 5 for two patients, segment 7-8 in two patients, segment 7 in one patient, and 8 in one patient. Liver biopsy was performed in five patients because it could not be distinguished from malignancy by imaging methods. Histopathological results of all these biopsies defined as IPT. Initial tumor median size was 31 (17-55) mm. Two patients were operated on. The first one underwent right hepatectomy due to a 2-fold increase in size within 11 months. The second one had a mass indistinguishable from hepatic adenoma by MRI and underwent nonanatomic resection. In one patient, IPT disappeared completely in the 18^th month of follow-up period while it regressed in size in two patients. Two of our patients had a history of recurrent endoscopic retrograde cholangiopancreatography, which we noticed incidentally before IPT was diagnosed. IPTs are liver masses with low malignant potential and may shrink spontaneously during follow-up. We suspected that biliary tract interventions may be the cause of IPT.