Background/Aims: The dynamic thiol/disulfide homeostasis plays pivotal roles in many physiological mechanisms in an organism. We aimed to investigate whether dynamic thiol/disulfide homeostasis changes among patients with acute pancreatitis. Materials and Methods: This prospective trial contained 45 patients with acute pancreatitis and 45 sex-and age-matched healthy volunteers as control group. Thiol/disulfide homeostasis parameters were measured by a novel and automated assay, and detected results were compared between the two groups. Results: Disulfide/total thiol percent ratio and disulfide/native thiol percent ratios were significantly higher in acute pancreatitis group; besides the native thiol, total thiol levels and native thiol/total thiol percent ratios were significantly lower (for all p Conclusion: The thiol/disulfide homeostasis is impaired in acute pancreatitis with a shift toward the oxidative status, and this deficiency might be a pathogenic factor in acute pancreatitis. The correction of this thiol/disulfide imbalance may be a new target in the management of acute pancreatitis. Cite this article as: Köseoğlu H, Alışık M, Başaran M, et al. Dynamic thiol/disulphide homeostasis in acute pancreatitis. Turk J Gastroenterol 2018; 29: 348-53.

Chylopericardium is a very rare complication after open heart surgery that is performed by median sternotomy. It is defined as uncontrollable chylous fluid loss, and may lead to hypoproteinemia, malnutrition, and immune deficiency; hence, overall increases postoperative morbidity. In this report, we present a case in which chylopericardium developed after coronary artery bypass grafting. The patient has been successfully treated; however, postoperative course was majorly complicated with the consequences of chylous fluid loss. Interestingly, the cause of the drainage was a lymphatic channel in the mediastinum. To the best of our knowledge, this is the first report in the literature in which a lymphatic channel has been demonstrated sporadically in the mediastinum as a cause of chylopericardium following open heart surgery in the adulthood.

Giriş ve Amaç: Serum iskemi modifiye albümin, iskemi ve oksidatif stresi göstermede kullanılan faydalı bir belirteçtir. Bu çalışmada serum iskemi modifiye albümin ve iskemi modifiye albümin tabanlı modellerin karaciğer fibrozisini öngörmede rolünün değerlendirilmesi amaçlandı. Gereç ve Yöntem: Çalışmaya 2013-2016 tarihleri arasında kronik karaciğer hastalığı ön tanısıyla karaciğer biyopsisi yapılan hastalar dahil edildi. Hastaların biyopsileri tek bir patolog tarafından değerlendirildi. Fibrozis derecelerine göre hastalar sınıflandırıldı. Tüm olguların hemogram parametreleri, kreatinin, aspartat aminotransferaz, alanin aminotransferaz, total bilirübin, direk bilirübin, albümin, iskemi modifiye albümin ve iskemi modifiye albümin oranı düzeyleri değerlendirildi. Bulgular: Çalışmaya karaciğer biyopsisi yapılan toplam 34 olgu alındı. Fibrozis deresine göre 15 olgu hafif, 15 olgu orta ve 4 olgu ileri fibrozis grubundaydı. Gruplar arasında ortalama iskemi modifiye albümin ve iskemi modifiye albümin oranı düzeyleri anlamlı farklı saptandı (sırasıyla; p = 0.031, p = 0.044). Gruplar arası değerlendirmede ileri fibrozis grubunda ortalama iskemi modifiye albümin ve iskemi modifiye albümin oranı; orta ve hafif fibrozis grubuna göre anlamlı farklı saptandı (sırasıyla; p = 0.009 ve p = 0.026, p = 0.014 ve p = 0.029). Hafif ve orta fibrozis grupları arasında ortalama iskemi modifiye albümin ve iskemi modifiye albümin oranı açısından anlamlı farklılık saptanmadı (sırasıyla, p = 0.545 ve p = 0.673). Sonuç: Karaciğer hastalıklarında ileri evre fibrozisi göstermede iskemi modifiye albümin ve iskemi modifiye albümin oranı etkin bir serum belirteci olarak kullanılabilir.

Esophageal necrosis, also known as necrotizing esophagitis or black esophagus, was first described in 1990. The incidence of this condition has been reported in various studies to range between 0.014% and 0.0125%. The mortality rate of esophageal necrosis can be as high as 32%. Additionally, esophageal necrosis is among the rare causes of upper gastrointestinal bleeding. Management primarily involves addressing underlying causes and providing supportive care. The mortality rate remains high due to the severity of the condition.

Crohn’s disease is a chronic inflammatory bowel disease that can affect any part of the gastrointestinal tract, most frequently the ileocecal region. Esophageal involvement is rare in adults and may present with atypical endoscopic findings. A 50-year-old male patient diagnosed with Crohn’s disease presented with severe diarrhea, nausea, and retrosternal pain. Ileocolonoscopy findings were normal. Upper endoscopy revealed a black-gray membranous appearance in the middle and distal esophagus, suggestive of acute esophageal necrosis. Magnetic resonance enterography showed diffuse small bowel wall thickening consistent with disease activation. Infliximab therapy was initiated, resulting in clinical improvement and complete endoscopic resolution within 3 months. Esophageal involvement in Crohn’s disease is rare and may mimic acute esophageal necrosis. Anti-TNF therapy can provide clinical and endoscopic remission in such atypical cases.