Purpose. Bezoars are foreign particles from the accumulation of indigestible materials in the gastrointestinal system and a rare cause of mechanical intestinal obstruction. We aimed at investigating differences in risk factors for the development of intestinal obstruction associated with bezoar in elderly patients.Methods. Hospital records of patients who underwent surgery associated with phytobezoar between January 2004 and May 2016 were retrospectively evaluated. Patients were divided into two groups [<65 years (Group 1) and ≥65 years (Group 2)]. Data were examined regarding presence of comorbidity, history of abdominal surgery, operation time, bezoar site, surgical technique, length of hospitalization, morbidity, and mortality.Results. Of 121 patients enrolled, 48 (39.7%) were male and 73 (60.3%) were female (range: 24-86 years). Group 1 consisted of 69 patients aged < 65, while Group 2 consisted of 52 patients aged ≥ 65. Comorbidity was reported in 52 (42.9%) patients (mostly diabetes mellitus, 20.7%), while 60 patients (49.6%) had history of abdominal surgery (mostly peptic ulcer, 27.3%). No statistical differences were found between the two groups in terms of sex, bezoar site, surgical technique preferred, history of abdominal surgical intervention, pre- and postoperative CT examination, morbidity rates, and length of hospitalization. But, ratio of peptic ulcer operations history, presence of total comorbidity, and time of surgery decision was higher in Group 2 patients.Conclusion. In bezoar-related intestinal obstruction, duration and outcome of treatment are not affected by age distribution. Possibility of bezoar should primarily be considered in elderly patients with history of peptic ulcer operation.

Aim. This paper investigates the risk factors preventing the reversal and nonreversal of Hartmann’s procedure, as a surgical technique that has been performed in our clinic for ten years. Methods. The study involved a ten‐year Hartmann’s procedure followed up at our center. The patients were divided into Hartmann reversal and nonreversal groups. Groups were examined in terms of age, gender, diagnosis, stage of malignancy, ASA score, comorbidity, perioperative morbidity‐mortality, and the length of the operation. Results. Age (p < 0.001), ASA score (p < 0.001), stage in case of malignancy (p = 0.002), and comorbidities (p < 0.001) were significant risk factors. The ratio of patients without any comorbidities to those with one or more comorbidities was 2.63 (95% CI 1.12–6.20). Among the malignant patients, the ratio of early‐stage patients to advanced‐stage patients in the group with reversal of Hartmann’s colostomy was 2.82 (95% CI 1.30–6.10). In addition, the ratio of older patients to younger patients in group 2 was 0.95 (95% CI 0.92–0.98). A univariate analysis revealed that younger patients, those with lower ASA scores, those without comorbidities, and those with early‐stage malignancy had a greater chance of closure of the stoma. Conclusion. Although Hartmann’s procedure is performed in emergency surgery, the nonreversal of the colostomy is a problem in itself. It should be kept in mind that patients who have high risks are likely to have a permanent stoma.

There are many applications to emergency services due to acute colonic diverticulitis. It is necessary to decide whether these patients are complicated, to quickly predict their prognosis, and to decide whether medical or invasive treatment is necessary. We planned to research effectiveness NLR, NLR, SII, and SIRI values calculated using hemogram data can predict the prognosis of acute diverticulitis. We managed a retrospective scanning with patients who applied with a diagnosis of acute diverticulitis between 06/2020 and 04/2023. Demographic data (age, gender, previous surgery, comorbid diseases), tomographic Hinchey classification, location of diverticulitis, applied treatment, and obtained from blood parameters at presentation to the emergency department WBC, CRP, NLR, dNLR, SII, SIRI parameters were recorded from the electronically registered patient files. According to the Hinchey classification, those with Hinchey 0 and 1a were included in the noncomplicated group A class because they were followed up with outpatient medical follow-up. Those with Hinchey 1b,2,3,4 were included in the complicated GROUP B class. Differences in WBC, CRP, NLR, dNLR, SIRI, SII values between the complicated and noncomplicated groups were evaluated statistically. There were 286 patients with acute diverticulitis on the dates indicated. The number of patients eligible for the study was eighty-two. According to Hinchey’s classification, 56 patients had noncomplicated acute diverticulitis (SAD) and 26 patients had complicated diverticulitis (CAD). These diagnoses were given based on tomography findings and clinical evaluations. The hospital stay was longer in the CAD group compared to the SAD group (p < 0.001) statistically significantly. The rate of surgical procedures and percutaneous interventions in the CADs was higher than SADs (p: 0.040) statistically significantly. WBC (white blood cell), NLR, dNLR, SIRI, SII and CRP parameters were higher in CADs than in SADs as statistically significant. Spearman’s correlation analysis showed between the Hinchey classification and the NLR, dNLR, SII, SIRI, CRP, WBC parameters with high correlation as positive. Determination of values SIRI (2.42), NLR (3.35), SII (907.44) dNLR (4.63), CRP (15.25) WBC (11.16) and specificity and fractionation of these values ROC analysis was performed for this purpose. Highest AUC (area under the curve) value was found in WBC [0.807 0.703–0.910)], SIRI [0.786 (, 0.681–0.892)], SII [0.767 (0.654–0.880)], NLR [0.740 (0.624–0.854)], dNLR [0.739 (0.625–0.853)]. This study showed that there are SII, SIRI dNLR, NLR, CRP, and WBC values in patients presenting with acute diverticulitis a very high correlation with Hinchey classification in distinguishing complicated and non-complicated acute diverticulitis ( p < 0.01). These data were higher in CADs than in SADs statistically significantly. The use of these data can both prevent unnecessary radiation in patients suspected of acute diverticulitis by reducing unnecessary tomography scans and can be valuable in predicting the prognosis of diverticulitis at a low cost.

Abdominal cocoon syndrome (ACS) is a rare situation and has an unknown etiology. Patients are characterized by the development of intraabdominal fibrotic tissue surrounding the small intestine as a result of chronic inflammation of the peritoneum. Small bowel perforations due to foreign bodies are not frequent in clinical practice. The coexistence of these two rare situations are extremely uncommon. In this article, the radiological findings and treatment process of the patient who presented with acute abdomen syndrome findings and the association of these two rare conditions are presented.

[This corrects the article DOI: 10.1155/2019/3647356.].

Percutaneous cholecystostomy (PC) has emerged as a valuable alternative to early cholecystectomy for managing acute cholecystitis (AC) in high-risk patients, particularly those classified as grade II or III according to the Tokyo Guidelines (TG). However, the criteria for optimal patient selection and predictors of definitive surgical needs remain inadequately defined. This single-center, retrospective study included 30 patients who underwent PC for AC between 2022 and 2025. Patients were classified as having TG18 grade II or III AC. Demographic characteristics, clinical scores (American Society for Anesthesiologists [ASA] and Charlson Comorbidity Index), laboratory parameters (neutrophil-to-lymphocyte ratio [NLR], platelet-to-lymphocyte ratio [PLR], and systemic immune-inflammation index [SII]), length of hospital stay, intensive care unit (ICU) and total parenteral nutrition (TPN) needs, and outcomes, including 30-day and 12-month mortality, and the need for interval cholecystectomy, were analyzed. Patients with grade III AC exhibited significantly higher NLR and lower lymphocyte counts ( P = .042 and P = .005, respectively). ICU admission, TPN requirements, and 12-month mortality rates were significantly higher in this group. Post-PC cholecystectomy was performed in 30% of patients, and those requiring surgery had higher ASA scores, experienced prolonged hospitalization, and an elevated mortality rate ( P < .05). No major PC-related complications were observed. PC was a safe and effective alternative for high-risk patients with AC. However, many patients with higher ASA scores and severe grades still require surgery and experience higher mortality. Accurate patient selection, therefore, is essential to achieve better outcomes and avoid unnecessary procedures. These findings support personalized guideline-based decisions and identify clinical and laboratory factors that may predict the need for surgery and prognosis.