BACKGROUND: Acute mesenteric ischemia is especially seen in the elderly population. It has an increasing incidence in today's world, where the average life expectancy is increasing. Early diagnosis is the most important factor reducing morbidity and mortality, and there is still no marker with high sensitivity and specificity for early diagnosis. In this study, we aimed to find a more sensitive and specific serum marker in the early diagnosis of mesenteric ischemia by comparing thiol with the currently used markers C-reactive protein (CRP) and lactate.METHODS: In our study, 32 Wistar Albino male rats, 10-12 weeks old, weighing 250-300 g, were used. 32 rats were divided into four groups, one of which was the control group. The superior mesenteric artery of the other three groups was ligated. Blood samples were taken after 2 h from the first group, 4 h from the second group, and 6 h from the third group. Then the rats were sacrificed. Mesenteric ischemia and its level were observed in sacrificed subjects. The samples were separated under appropriate conditions and analyzed biochemically.RESULTS: As the ischemia time increased, CRP increased and this increase was found to be statistically insignificant (P>0.05). The changes in lactate were found to be statistically significant (P<0.05). The difference between the changes of total and native thiol values was found to be statistically significant (P<0.05).CONCLUSION: Although CRP is a non-specific parameter in the early diagnosis of acute mesenteric ischemia, lactate maintains its importance as seen in our study. Differences in total thiol and native thiol changes were statistically significant. The fact that this significant difference is observed at the 4th h values reveals the importance of these parameters in early diagnosis. Thanks to the economic and fast results of thiol parameters, it is thought that new studies to be added to the literature can lead to the diagnosis of mesenteric ischemia.

Peptic ulcer perforation remains a life-threatening surgical emergency associated with considerable postoperative mortality. Identifying reliable preoperat

Background/Aims: Levator ani syndrome (LAS) is a pathology that is both difficult to diagnose and treat. The effectiveness of curren treatments, which are mostly administered with special devices in advanced healthcare centers, is controversial. The aim of the study is to investigate the effects of glyceryl trinitrate, which is easily accessible and can be applied by the patient, in the treatment of LAS. Materials and Methods: The study cohort comprised 16 patients with LAS diagnosed and received 0.4% topical glyceryl trinitrate treatment rectally. Results: At the first month of treatment, it was observed that the symptoms and puborectal muscle tension of 15 (93.7%) patients had completely resolved. One patient with persisted symptoms was referred to an advanced center. Symptomatic relief continued in 14 (87.5%) of the 15 patients at the third month of treatment and there were no pathological findings in the rectal examination. The visual analog scale score significantly decreased after the treatment (P < .001). Conclusion: It is thought that topical glyceryl trinitrate treatment may be at least as effective as current treatment methods. Although the number of patients is small, our study is inspiring as it is the first time this molecule has been tried in the treatment of LAS in the literature. More comprehensive randomized controlled studies with long-term follow-up of patients are needed. Cite this article as: Canlıkarakaya F, Ocaklı S. Can topical glyceryl trinitrate be effective in the treatment of levator ani syndrome? Turk J Gastroenterol. 2025;36(5):328-332.

Acute diverticulitis is an inflammatory process associated with pericolonic inflammation involving one or more colonic diverticula and is usually classified as uncomplicated or complicated. This multicenter study retrospectively examined the data of 135 patients who received inpatient treatment for diverticulitis in two tertiary hospitals. Some inflammation scores were calculated with the data obtained from the patients' Complete blood count(CBC) and biochemical laboratory results, and the power of these scores in predicting complicated diverticulitis was examined. A total of 135 patients (57 men and 78 women) were included in this study. In the ROC analysis performed to evaluate the effectiveness of predicting complications, the CRP/Albumin(CAR) score was found to be significant (AUC: 0.762, p = 0.001). For a cutoff value > 0.25, CAR predicted complications with 73% sensitivity and 76% specificity (AUC: 0.762, p = 0.001). Determining the severity of the disease by differentiating complicated from uncomplicated cases will contribute to reducing hospital stay times and related costs. Our study showed that CAR score can be used as a reliable, inexpensive, and rapid marker for predicting complicated diverticulitis in acute diverticulitis.