The current study was conducted to clarify whether the neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) are clinically useful in predicting postoperative mortality among patients undergoing surgery for acute intestinal ischemia (AII). The study was conducted as a retrospective investigation of 37 consecutive patients operated for AII between January 2014 and September 2019. Data regarding potential prognostic factors, including age, sex, preoperative white blood cell count (WBC), C-reactive protein (CRP), neutrophil, lymphocyte, and platelet counts were obtained from medical records. Univariate analysis revealed that age, WBC, and neutrophil count were predictors of postoperative mortality. In multivariate analysis, age (OR =1.14; 95% CI, 1.005-1.303; P=0.02) was found to be the only independent variable predicting postoperative mortality. Preoperative NLR and PLR cannot be used as independent variables to predict postoperative 30-day mortality in patients with AII who underwent surgery.

Adrenal incidentalomas (AI) are adrenal masses that are discovered during radiological examinations conducted for other reasons. In this study, we focused on the pathological and radiological properties of nonfunctional AI(NFAI) and the association with malignancy risk in our clinical series. A total of 186 patients underwent adrenalectomy between 2010 and 2017; of these, 76 (40.8%) patients with non-functional AI were included in the current study. The radiological and pathologic characteristics of these AIs were retrospectively analyzed to determine the malignancy rate. There were 22 (28.9%) male and 54 (71.1%) female patients with nonfunctional AI included in this study. The median age was 55 (range: 24-85) years. Of the patients included, 37 (48.6%) had AI on the left and 39 (51.3%) had AI on the right adrenal gland. Sixty-one (80.2%) cases were treated laparoscopically, four (5.3%) required conversion to open surgery due to intraoperative difficulties such as bleeding and adhesions, and 11 (14.4%) were managed with open adrenalectomy. The rate of malignancy in the tumors with diameters of 6 cm was found to be 0%, 2.9%, and 13.6%, respectively. Determining the ideal cutoff value for surgical indication in an NFAI is challenging. Besides the malignancy risk, the rate of silent pheochromacytomas must be taken into account in the surgical decision.

Fournier’s gangrene is necrotizing fasciitis involving the penis, scrotum, or perineal region. This condition is associated with a high mortality rate and requires aggressive debridement of necrotic tissues. It is mainly seen in elderly, immune-suppressed, diabetic patients, or patients with long-term urinary catheterization. Isolated penile involvement is very rare due to the rich blood supply of the organ and is thought to be induced by penile trauma with partial involvement of the urethra. In this study, we present a patient with isolated penile and urethral necrosis rather than scrotum and perineum and emphasize its gastrointestinal source.