Objectives: Fournier’s gangrene is an aggressive, rapidly progressing, and life-threatening necrotizing fasciitis of the perineal and genital regions. Various scoring systems have been developed for predicting survival and prognosis in Fournier’s gangrene. This retrospective study aimed to evaluate the effectiveness of the newly developed Fournier’s gangrene mortality index (FGMI) in predicting mortality associated with Fournier’s gangrene. Methods: The study included patients over the age of 18 years who were followed-up with a diagnosis of Fournier’s gangrene in the general surgery clinics of three different hospitals in Şanlıurfa province between 2014 and 2024. The patients included in this study were divided into two groups: deceased (n = 20) and surviving (n = 149). In FGMI, the parameters used were age, creatinine level, albumin level, lymphocyte percentage, and neutrophil-to-lymphocyte ratio. Based on the total score and risk assessment, <5 points were categorized as low-to-moderate mortality risk and ≥5 points as high mortality risk. Results: A total of 169 patients with a diagnosis of Fournier’s gangrene were included in the study; 87 were men (51.48%). The median age of all patients was 53 (40–63) years; 20 patients (11.8%) died. The Laboratory Risk Indicator for Necrotizing Fasciitis (LRINEC) score did not show a statistically significant difference between the deceased and surviving groups (p = 0.5). Compared to the survivors, the deceased had higher neutrophil counts, neutrophil percentages, neutrophil-to-lymphocyte ratios, platelet-to-lymphocyte ratios, and C-reactive protein-to-albumin ratios, whereas lymphocyte counts, lymphocyte percentages, eosinophil counts, eosinophil percentages, monocyte counts, and monocyte percentages were lower, and these differences were statistically significant. According to receiver operating characteristic (ROC) analysis, the ROC-area under the curve for predicting mortality based on an FGMI score of ≥5 was 0.88 (95% CI: 0.80–0.95) with a sensitivity of 90% and a specificity of 70% (p < 0.001). Univariate risk analysis was performed, and the odds ratio revealed that mortality risk in patients followed-up for Fournier’s gangrene with a FGMI score of ≥5 was 20 times higher (4.48–90.91) (p < 0.001). Conclusions: The results reveal that the FGMI score is a scoring system that can predict mortality at the initial clinical presentation of patients with Fournier’s gangrene. Another important finding of the present study is that the LRINEC score was not sufficiently effective in predicting mortality.

Background and Aim: Hydatid cyst is caused by Echinococcus larvae and prevalent in endemic areas worldwide. We analyzed post-procedure complications and outcomes of patients with liver hydatid cyst. Materials and Methods: We included patients who managed either by surgery or percutaneous drainage (PAIR) for hydatid liver cysts at SBÜ University Mehmet Akif İnan Hospital between January 2017 and February 2021. Age, sex, segmental location, size, number, Gharbi classification, treatment modality, length of hospital stays, and complications were recorded. Results: We included total of 209 patients who were managed by hydatid liver cysts. Among them, 74 post-procedural complications were developed in total of 69 (33%) patients. Biliary fistula was the most prevalent complication (n=38, 18.2%). Hospitalization duration was median 5 days (2-36) and was 5 days (2-36) in patients underwent surgery and 3 days (range:2-7) in patients managed by PAIR. Patients with cyst diameter ≥ 9.5 cm were predicted to have an increased risk of complications with 70% sensitivity and 60% specificity. More patients experienced any complications in patients who managed by PAIR than those underwent surgery (65.4% vs 28.4%, p

Background/Aims: Endoscopic retrograde cholangiopancreatography (ERCP) is an essential diagnostic and therapeutic method for pancreato-biliary disorders in adults, but its use in pediatric populations remains limited. This study aims to evaluate the indications, technical success, and safety of ERCP in pediatric patients. Materials and Methods: A retrospective analysis of all ERCP procedures performed on patients under 18 years of age was conducted at 2 tertiary centers in Türkiye (Harran University and Gaziantep University Hospital) during the period between January 2013 and May 2024. The data used for the study were obtained from patients’ medical records. Results: A total of 153 ERCP procedures were performed on 83 pediatric patients (64%, female) with a mean age of 12.9 years (range 3-17) at the time of ERCP. Common bile duct stones were the most frequent indication (n = 39, 47%) for ERCP, followed by biliary hydatid cyst-related complications (n = 24, 29%). The overall cannulation success rate was 98.7% (82/83). Endoscopic sphincterotomy was performed in 79 (95%) patients. More than one ERCP procedure was performed in 41 (49%) patients. Stones were extracted in 32 patients (30 were biliary and 2 pancreatic). Stent placement was performed in 33 patients (25 biliary and 8 pancreatic). Post-ERCP pancreatitis developed in 4.8% (n = 4) of patients, and all classified as mild. Ten (12%) patients developed mild/moderate cholangitis following ERCP. One patient (1.2%) experienced minor bleeding. About half of the patients (48%) were discharged within 1 day postprocedure. No patient experienced procedure-related mortality. Conclusion: Our study results indicate that ERCP is both effective and safe in the pediatric population. Cite this article as: Batıbay E, Yüksekyayla O, Polat M, et al. Endoscopic retrograde cholangiopancreatography in pediatric population: A decade-long experience from 2 tertiary centers. Turk J Gastroenterol. Published online January 13, 2025. doi 10.5152/ tjg.2025.24462.

Background: Acute appendicitis is the acute inflammation of the appendix vermiformis and is one of the leading emergency intra-abdominal surgeries. In the study; To investigate the effectiveness of preoperative USG and CT in the diagnosis of acute appendicitis. Materials and Methods: The records of 332 patients who underwent appendectomy between March 2018 and March 2023 were retrospectively examined. Gender, age, USG and CT reports and patho-logy results of the patients were recorded. Sensitivity, specificity, positive predictive value and negative predictive values of USG and CT in the diagnosis of acute appendicitis were calculated separately. Results: The pathology result was reported as acute appendicitis in 312 of the patients, and was evaluated as normal in 20 of them. The pathology result of 254 of 261 patients, whose CT results were evaluated as compatible with acute appendicitis, was reported as acute appendicitis. In 7 patients, it was found to be normal appendicitis. Of 28 patients whose CT results were incompatible with acute appendicitis, the pathology result was positive in 18 and negative in 10. Pathology results of 96 patients whose USG results were compatible with acute appendicitis; Acute appendicitis was found in 90 patients and normal appendix in 6 patients. Pathology results of 41 patients whose USG results were evaluated as negative; It was reported to be compatible with acute appendicitis in 36 cases and normal in 5 cases. Conclusions: In our study, both the sensitivity and specificity of CT were found to be superior to USG, consistent with the literature. Researching IT effectiveness; We think that prospective studies com-paring teleradiology reports and the reports of radiologists working in hospitals would be useful.

Background: Inguinal hernia (IH) repair is generally considered safe with low morbidity and mortali-ty; however, the risk increases in geriatric patients due to the prevalence of comorbid conditions. This study aims to compare the outcomes of elective versus emergency IH repair in elderly pa-tients. Materials and Methods: Patients aged 65 years and older who underwent surgery for IH at Balıklıgöl State Hospital and Akçakale State Hospital between 01.12.2022 and 01.02.2024 were retrospec-tively reviewed. The patients were divided into two groups as emergency (G-EM) and elective (G-EL) surgery. Age, gender, comorbidities, type of operation, length of hospitalization and postoperative complications were recorded. Postoperative complications were recorded as wound infection, seroma and ileus. Results: The study included 72 patients. Sixty-one (84.7%) patients were in the G-EL group and 11 (15.3%) were in the G-EM group. The G-EL group was composed entirely of males, with a mean age of 70.9 years (range: 65-86), while the G-EM group included 6 males (54.5%) and 5 females (45.5%), with a mean age of 71.2 years (range: 65-89). The length of hospitalization was significantly shorter in the G-EL group (1.39 ± 0.62 days) compared to the G-EM group (4.50 ± 2.51 days, p < 0.001). Postoperative complications were occurred in 5 (45.6%) patients in the G-EM group and in 7 (11.5%) patients in the G-EL group, a significant difference was found (p=0.015). No mortality was observed in both groups. Conclusions: Although IH repair in the geriatric population is a concern due to comorbidities, we recommend elective mesh hernia repair for patients diagnosed with inguinal hernia to avoid the high complication rate after emergency repair as seen in our study and in the literature.