Background/Aims: Inflammatory bowel diseases (IBDs) are increasingly prevalent and challenging globally. Data regarding IBD frequency and severity between Europe and Asia are needed. The aim was to investigate the trend of IBD in Türkiye during the last 3 decades. Materials and Methods: The study was conducted retrospectively at 14 centers in Türkiye between June 1993 and March 2024. Results: Over 30 years, 4308 patients, of whom 2507 (58.2%) had ulcerative colitis (UC) and 1717 (39.9%) had Crohn’s Disease (CD), were included in the study. The overall median age at the onset of IBD was 34.43 (25.28-45.64) years; the age at onset of IBD was younger in CD compared to UC (32.72 vs. 35.52 years respectively, P < .001). The peak age onset range was 28-32 years in CD, whereas 23-27 years in UC. Overall, 2526 (58.6%) patients were male. The most common location was left-sided colitis in UC patients (45.1%), followed by extensive colitis (31.2%), and proctitis (23.7%), while ileal involvement in CD patients (45.2%), afterward ileocolonic (409%), and colonic (13.5%). Both illnesses are becoming increasingly prevalent. The UC/CD ratio tends to decrease over time. During the study period, 1577 (36.6%) patients received biologic treatment. During the study period, 418 (24.3%) underwent resective surgery for CD and 88 (3.5%) total colectomy for UC; the major abdominal surgery has declined over time. Conclusion: The frequency and characteristic features of IBD in Türkiye appear to be between Europe and Asia. Over time, while the usage of biologic therapy and the rate of CD have increased, the frequency of surgery has decreased. Cite this article as: Durak MB, Cagin YF, Balkan A, et al. Three-decade analysis of inflammatory bowel disease in Türkiye: A multicenter study (1993-2024). Turk J Gastroenterol. 2025;36(12):822-833.

Amaç: Kolesistektomi sonrası gelişen biliyer kaçak tedavisinde Endoskopik Retrograd Kolanjiyopankreatografi (ERCP) ile yerleştirilen biliyer stent veya nazobiliyer dren (NBD) tercih edilen prosedürlerdir. Çalışmamızda, biliyer kaçak tespit edilen hastalarda NBD veya biliyer stentin etkinliğini karşılaştırmayı amaçladık. Materyal ve metod: Postkoleksistektomi safra kaçağı olan 37 hasta çalışmaya dahil edildi. 20 hastaya biliyer stent, 17 hastaya NBD uygulandı. Hastalar; ek işlem gereksinimi, ERCP komplikasyonları, hastanede yatış süresi, toplam takip süresi açısından karşılaştırıldı. Bulgular: Biliyer stent uygulanan 20 hastanın 11’inde (%55) sistik güdükten, 5’inde (%25) Luschka’dan, 4’ünde(%20) lateral duvardan kaçak vardı. Hastanede yatış süresi 10.5±7 gün iken, toplam takip süreleri 89.9±42.8 gün di. NBD uygulanan 17 hastanın 10’unda (%58.8) sistik güdükten, 4’ünde (%23.5) lutckadan , 2’sinde(%11.7) lateral duvardan, 1’inde (%5.8) sağ segmental duktustan kaçak vardı. Hastanede yatış süresi 11.9±3 gün iken, total takip süreleri 31.5±11.7 gündü. Ayrıca kaçak lokalizasyonuna gore; 1. grupta (Strazberg tip A) hospitalizasyon süresi 9±2.25 gün, toplam takip siresi 54.04±6.72 iken, 2. grupta (Strazberg tip A dışı) hastanede yatış süresi 16.9±2.68 gün, toplam takip süreleri 84±40,15 gündü. Sonuç: Biliyer stent uygulanan hastalarda, hastanede yatış süresinin daha kısa olduğu ve komplikasyonların daha az geliştiği, tesbit edildi. NBD'li hastalarda toplam takip süreleri daha kısaydı. Ayrıca çalışmamız uygulanacak modalitenin belirlenmesinde kaçak yerinin de göz önüne alınması gerektiğini düşündürmektedir

Objective: Aortoenteric fistula (AEF) is a rare but potentially fatal cause of gastrointestinal bleeding. It can be classified as primary or secondary, with the latter most commonly occurring after aortic graft surgery. Due to the severe and rapid nature of hemorrhage, the endoscopic diagnosis of AEF is highly challenging, and there is no specific endoscopic appearance of the lesion. Furthermore, invasive endoscopic interventions may precipitate life-threatening rebleeding. This case highlights the endoscopic and radiological findings of a primary AEF presenting with massive upper gastrointestinal bleeding, which subsequently achieved spontaneous hemostasis. Case: A 73-year-old male patient on anticoagulant therapy due to coronary artery disease and atrial fibrillation was admitted to the emergency department after hematemesis, melena, and syncope. Initial assessment revealed hypotension and anemia. Esophagogastroduodenoscopy (EGD) showed a 2.5 cm polypoid lesion with a central fibrin plug in the third part of the duodenum. Given the suspicion of AEF, no endoscopic therapeutic intervention was attempted. Cross-sectional imaging confirmed the presence of a 48×26 mm saccular aortic aneurysm abutting the duodenum. The patient was diagnosed with primary AEF and referred for urgent surgical intervention. Conclusion: AEF should be considered in the differential diagnosis of upper gastrointestinal bleeding, particularly in patients with risk factors such as advanced age, male sex, and cardiovascular comorbidities. Endoscopic interventions should be avoided in suspected cases to prevent catastrophic rebleeding. Rapid diagnostic imaging and prompt surgical referral are essential to improve patient outcomes.

Chronic hepatitis B (CHB) remains a major cause of cirrhosis and hepatocellular carcinoma worldwide. Although liver biopsy is the reference standard for fibrosis staging, its limitations have prompted the development of noninvasive serum-based indices. This study aimed to compare aminotransferase-to-platelet ratio index (APRI), Fibrosis-4 index (FIB-4), Fibrosis-5 index (FIB-5), Fibrosis-6 index (FIB-6), and serum fibrozis indeksi (S-Index) with histology in patients with CHB. A total of 191 CHB patients who underwent liver biopsy between 2012 and 2024 were retrospectively analyzed. Fibrosis was staged using the METAVIR system and classified as non-significant (F0–F2) or significant (F3–F4). Serum-based fibrosis indices were calculated, and their diagnostic performance was assessed using receiver operating characteristic (ROC) analysis. Of the 191 patients, 75 (39.3%) had significant fibrosis (SF). APRI, FIB-4, FIB-6, and S-Index were significantly higher in patients with SF, whereas FIB-5 showed no discriminatory value. ROC analysis demonstrated modest accuracy overall: APRI (area under the curve [AUC] 0.661) provided the highest sensitivity but low specificity (88.0% and 38.8% respectively, P < .001), while FIB-4 (AUC 0.601, specificity 86.2% sensitivity 37.3%, P = .019) and FIB-6 (AUC 0.608, specificity 87.1%, sensitivity 44%, P = .014) were more specific but less sensitive. S-Index showed intermediate performance (AUC 0.601, specificity 62.07% sensitivity 58.67%, P = .021). Serum-based indices demonstrated limited but clinically relevant ability to discriminate SF in CHB, with modest AUC values. Despite their suboptimal diagnostic accuracy, their noninvasive, low-cost, and accessible nature supports their potential role in clinical practice. APRI showed high sensitivity but low specificity, limiting its standalone screening utility. FIB-4 and FIB-6 displayed relatively balanced performance, while S-Index showed modest but consistent accuracy. Overall, these scores may serve as adjunctive tools rather than definitive diagnostic methods and could have a role in longitudinal monitoring. Further validation in larger, multicenter prospective studies is warranted.

Cite this article as: Ergul M, Ozturk O, Ayte MR, et al. Lumen-apposing metal stent as a salvage therapy for corrosive-induced gastric outlet obstruction: A case report. Turk J Gastroenterol. Published online August 18, 2026. doi: 10.5152/tjg.2026.25719