Background/Objectives: Acute pancreatitis (AP) is a highly variable inflammatory condition that can lead to severe complications and high mortality, particularly in its severe forms. Early risk stratification is essential; however, the delayed availability of traditional scoring systems often limits its effectiveness. This study aimed to evaluate the clinical utility of systemic inflammation indices as early predictors of severity in patients with acute pancreatitis. Methods: A retrospective, observational study was conducted among patients diagnosed with acute pancreatitis, classified according to the revised Atlanta criteria. Upon admission, systemic inflammation indices were calculated from complete blood count parameters, including neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), and aggregate index of systemic inflammation (AISI). Severity was assessed using the APACHE II score. Statistical analysis involved Kruskal–Wallis tests, Dunn’s post hoc comparisons, ROC curve analysis, logistic regression for odds ratios (ORs), and Spearman correlations. Results: SII, NLR, MLR, SIRI, and AISI showed statistically significant associations with AP severity (p < 0.05). MLR and SIRI exhibited the highest predictive performance (AUC = 0.74). ORs for severe pancreatitis were: MLR = 19.10, SIRI = 7.50, NLR = 7.33, AISI = 5.12, and SII = 4.10. All four indices also demonstrated moderate positive correlations with APACHE II scores. Conclusions: Systemic inflammation indices are simple, cost-effective, and accessible tools that can aid in the early identification of patients at high risk for severe acute pancreatitis. Their integration into clinical practice may enhance early decision-making and improve patient outcomes.

Fulminant amoebic colitis is a rare complication of amoebiasis that carries a high mortality rate. Its diagnosis is challenging and requires a high index of suspicion, and its early recognition is a priority to provide timely medical and surgical treatment. We present the case of a male patient who came to the emergency department with unspecific clinical presentation of abdominal pain, systemic inflammatory response and imaging study showing intestinal perforation of the right colon. Fecal peritonitis and perforation at the level of the hepatic flexure were observed, so a right hemicolectomy with terminal ileostomy was performed. Despite adequate medical and surgical treatment, the patient presented progressive deterioration and died. Colon perforation due to Entamoeba histolytica was the final diagnosis.

Introduction Stoma placement is a common surgical procedure that can be performed in the context of urgent and elective surgery for benign and malignant conditions, with an estimated morbidity ranging from 21% to 70%. Methods A retrospective cohort analysis to determine the incidence of stoma placement postoperative-related complications and potential associated factors. This study was conducted at a single tertiary care center in Mexico City including all patients who underwent a stoma construction between January 2016 and October 2023. Results A total of 276 patients underwent stoma construction. Eighty-one (29.3%) patients presented morbidity exclusively related to the ostomy.The multivariate analysis showed the following risk factors: advanced age for developing stoma-related complications; obesity for developing parastomal hernia; strangulated hernia and complicated diverticular disease for developing mucocutaneous dehiscence; bowel obstruction and parastomal hernia for developing stomal prolapse; anastomotic leak and preoperative corticosteroid therapy for developing parastomal abscess; and end-colostomy and advanced age for reoperation. Discussion Ostomy creation carries a high morbidity rate. Preoperative features such as advanced age, obesity, corticosteroid therapy, the indication of the surgery, as well as the type of the stoma created must be considered as they could significantly impact the development of adverse outcomes.

The gastrointestinal tract is the most frequent extranodal site of non-Hodgkin lymphoma (NHL), accounting for up to 40% of cases. However, appendiceal lymphoma is exceptionally rare, with peritoneal involvement being even rarer. Appendiceal lymphoma often mimics acute appendicitis (AA), although it is an uncommon initial manifestation of intestinal NHL, complicating diagnosis. We report a 29-year-old male with human immunodeficiency virus (HIV) who presented with AA. An open appendectomy was planned; however, intraoperative findings- including cecal induration, ascites, peritoneal thickening, and macronodular lesions on the peritoneum and intestines-led to abandonment of the procedure. Postoperative evaluation excluded peritoneal tuberculosis (PTB), while computed tomography (CT) suggested peritoneal carcinomatosis (PC). Histopathological analysis of a parietal peritoneum specimen provided the definitive diagnosis of NHL. Appendiceal NHL should be considered in HIV-positive patients with AA. Routine histopathological evaluation and surgical intervention are essential for accurate diagnosis and effective management.

The incidence of acute pancreatitis is 34 per 100 000 people in the general population and is on the rise. Approximately 15% to 20% of all patients experience severe pancreatitis, with a mortality rate nearing 20%. This condition is often linked to vascular complications, although mesenteric thrombosis is a rare presentation. We present two cases of severe acute pancreatitis resulting in multiple organ failure. Histopathological examination revealed acute hemorrhagic pancreatitis with necrosis and mesenteric thrombosis in both cases. Mesenteric thrombosis, though uncommon, is a serious complication with atypical symptoms and high mortality rates. Vascular complications in severe acute pancreatitis should not be overlooked. This case report underscores the significance of recognizing such rare complications and the need for comprehensive consideration in clinical assessments.