Acute pancreatitis (AP) is a clinical condition that arises acutely in the pancreas through various inflammatory pathways due to multiple causes. Turkish Society of Gastroenterology Pancreas Working Group developed comprehensive guidance statements regarding the management of AP that include its epidemiology, etiology, clinical presentation, diagnostic criteria, disease severity, treatment, prognosis, local and systemic complications. The statements were developed through literature review, deliberation, and consensus opinion. These statements were ultimately used to develop a conceptual framework for the multidisciplinary management of AP. Cite this article as: Öğütmen Koç D, Bengi G, Gül Ö, et al. Turkish society of gastroenterology: Pancreas working group, acute pancreatitis committee consensus report. Turk J Gastroenterol. 2024;35(S1):S1-S44.

Background/Aims: Pancreatic steatosis (PS) is a pathology associated with metabolic syndrome (MS), endocrin and exocrine disfunctions of the pancreas, and fatty liver. The data on the frequency of PS are very limited. We aimed to evaluate the frequency of PS detected by transabdominal ultrasonography (TAU) in gastroenterology clinics located in different geographical regions of Turkey and the factors associated with it. Materials and Methods: Volunteers were evaluated by TAU for PS and hepatosteatosis (HS), and its degree. Pancreatic stiffness was evaluated by ultrasonographic shear wave elastography (SWE). All demographic, physical, and biochemical parametres were measured. Results: A total of 1700 volunteers from 14 centers throughout Turkey were included in the study. Mean age was 48.03 +- 20.86 years (56.9% female). Prevalance of PS was detected in 68.9%. In the PS group, age, body mass index (BMI), waist circumference, systolic blood pressure, fasting blood glucose (FBG), lipid levels, insulin resistance, diabetes mellitus, hypertension, MS frequency, and pancreatic SWE score were increasing, and fecal elastase level was decreasing in correlation with the degree of PS. The frequency of HS was 55.5%. Hepatosteatosis [odds ratio (OR): 9.472], increased age (OR: 1.02), and BMI (OR: 1.089) were independent risk factors for the occurrence of PS. Lean-PS rate was 11.8%. The lean-PS group was predominantly female and younger than non-lean PS. Also it has lower blood pressure, FBG, liver enzymes, lipid levels, and HS rates. Conclusion: The frequency of PS was found 68.9% in Turkey. Its relationship was determined with age, BMI, HS, MS (and its components), pancreatic stiffness, and fecal elastase level. Keywords: Elastography, exocrine pancreatic insufficiency, lean steatosis, pancreas stiffness, pancreatic steatosis, ultrasonography Cite this article as: Sezgin O, Yaraş S, Cindoruk M, et al. Prevalence of pancreatic steatosis and its associated factors in Turkey: A nation-wide multicenter study. Turk J Gastroenterol. 2024;35(3):239-254.

Background: Acute pancreatitis is an abrupt inflammatory disease of the exocrine pancreas and it can occur in different severities. It is becoming more common and more mortal in the gerontal population. The aim of our study was to explore the similarities and differences between young and gerontal patients with acute pancreatitis, with a special emphasis on patients over 80 years of age. Methods: Medical records of patients (n = 1150) with acute pancreatitis were analyzed retrospectively. Several scoring systems including Bedside index for severity in acute pancreatitis, Ranson’s score, Harmless acute pancreatitis score, Acute Physiology and Chronic Health Evaluation, Balthazar Grade, Glasgow score, and Japanese severity score were applied at admission. Patients were divided into 3 groups; group I, young group (n = 706), if they were aged <65 years; group II, older group (n = 338), if they were aged ≥65 years to <80 years; group III, octogenarian group (n = 106), if they were aged ≥ 0 years. Results: In total, 1150 patients with acute pancreatitis were analyzed. Octogenarian group (n = 42, 39.6%) showed a more severe acute pancreatitis compared to patients in group I (n = 15, 2.1%) and II (n = 50, 14.8%, P < .001). Complications were more common in patients in group III (P < .001). Mortality rate was higher in patients in group III (n = 53, 50%) compared to group I (n = 8, 1.1%) and group II (n = 53, 15.7%) (P < .001). Conclusion: Gerontal patients with acute pancreatitis tend to have more severe disease and systemic and local complications. Mortality rates were higher in older patients compared to younger patients. Cite this article as: Asfuroğlu Kalkan E, Kalkan Ç, Kaçar S, et al. Similarities and differences between gerontal and young patients with acute pancreatitis: Evaluation of clinical characteristics and outcomes. Turk J Gastroenterol. 2022;33(10):874-884.

Background: Many rheumatic diseases may cause gastrointestinal manifestations. The goal of this study was to analyze the prevalence and predictors of gastrointestinal involvement in patients with rheumatic disorders. Methods: A retrospective chart review was performed for patients with systemic lupus erythematosus, rheumatoid arthritis, and sys- temic sclerosis who have consulted due to gastrointestinal symptoms. The relationship between clinical symptoms, gastroscopic/colo- noscopic findings, and histopathological results with current drugs and disease duration was evaluated. Results: A total of 364 patients with rheumatic disorders and 740 people as control group were included in the study. Abdominal bloating followed by abdominal pain, regurgitation, and heartburn were reported as the main complaints by more than half of the patients. Most of the patients had gastric mucosal changes expressed as Lanza score, and the presence of major polypharmacy was the most important factor affecting Lanza score (odds ratio: 10, 95% CI: 1.882-54.111, P < .007) followed by disease duration (odds ratio: 1.559, 95% CI: 1.369-1.775, P < .001) and age (odds ratio: 1.069, 95% CI: 1.030-1.109, P < .001). In general, approximately 30% of the patients were posi- tive for Helicobacter pylori infection and 35% showed intestinal metaplasia in histopathological examination. Most of the colonoscopic findings were associated with colonic polyps (n = 81). In multivariate analysis, disease duration was the only factor that affected the pres- ence of colonic lesions (Area Under the Receiver Operating Characteristic (ROC) Curve (AUROC): 0.871, 95% CI: 0.824-0.918, P < .001). Conclusion: Patients with rheumatologic diseases frequently have gastrointestinal manifestations. The most encountered gastrointes- tinal symptom was abdominal bloating, followed by abdominal pain. Being aware of gastrointestinal manifestations and their determi- nants may help physicians manage and follow patients with rheumatologic disorders.

Background and Aim: Early diagnosis and treatment of chronic hepatitis B (CHB) disease are important for the prevention of complications such as cirrhosis and hepatocellular cancer. Liver biopsy is an invasive, complicated, and expensive diagnostic method, which is the gold standard for detecting fibrosis. The aim of this study was to investigate the role of these tests in predicting liver fibrosis and treatment decision. Materials and Methods: A total of 1051 patients diagnosed with CHB between 2010 and 2020 in the Gaziantep University Gastroenterology Department were retrospectively evaluated. AAR, API, APRI, FIB-4, KING score, and FIBROQ score were calculated at the time of onset diagnosis. In addition, the Zeugma score, a new formula that is thought to be more sensitive and specific, was determined. Noninvasive fibrosis scores were compared according to the biopsy results of the patients Results: In this study, the area values under the curve were 0.648 for the API score, 0.711 for the APRI score, 0.716 for the FIB-4 score, 0.723 for the KING score, 0.595 for the FIBROQ score, and 0.701 for the Zeugma score (p

Background: Wilson disease (WD) is an autosomal recessive inherited disorder of copper (Cu2+) metabolism, resulting in Cu2+ accumulation and liver and central nervous system toxicity. Oxidative stress may have a role in the pathogenesis of Wilson disease, but the roles of thiol/disulfide homeostasis and nitrosative stress have not been examined. The purpose of this study was to evaluate whether there is a modification in thiol/disulfide homeostasis and nitrosative stress in patients with Wilson disease. Methods: A total of 50 patients with Wilson disease (42 under drug treatment and 8 newly diagnosed patients with no drug treatment) and 50 healthy gender- and age-matched controls were enrolled for this study. Serum native thiol and total thiol levels were measured with a spectrophotometric method. The number of disulfide bonds and the related ratios were determined from these measurements. Serum nitric oxide (NO) and 3-nitrotyrosine (3-NT) levels were analyzed using chemiluminescence and ELISA assays, respectively. Results: The average native thiol levels of the patient group under drug treatment were found to be markedly higher than the levels of controls (P < .05). We detected no marked changes in total thiol and disulfide levels, and disulfide/total thiol, disulfide/native thiol, or native thiol/total thiol ratios between groups. We found significant elevations in NO levels in Wilson disease group before drug treatment, and the 3-NT levels in the Wilson disease groups prior to (P < .05) and under drug treatment (P < .01), when compared to controls. Conclusion: Our data are the first to show that nitrosative stress and thiol/disulfide homeostasis can contribute to the pathogenesis of Wilson disease.