Aim: We aimed to determine the correlation between endoscopic and computed tomography (CT) grading scores in patients presenting after caustic ingestion and to evaluate their effectiveness in predicting the severity of lesions. Material and Methods: Patients aged 18 and older who presented to our emergency department due to caustic ingestion between 2019 and 2023 were included in the study. Clinical records of the patients were retrospectively analyzed. Results: A total of 57 patients (27 males, 47.4%; 30 females, 52.6%) were included in the study. The mean age of the patients was 41.6 (±17.0) years. CT findings and emergency endoscopic evaluation results at the time of emergency department presentation were compared. When the CT scores were compared with the Zargar classification, statistically significant similarities were found for both the esophagus and the stomach. Conclusion: This study suggests that CT evaluation in patients presenting with caustic ingestion may be as effective as emergency endoscopy. Additionally, for patients identified by CT as having a low likelihood of requiring an endoscopic intervention, treatment and follow-up may be feasible without performing emergency endoscopy.

Background and Aims: Dominant biliary strictures are a clinically important complication in primary sclerosing cholangitis that often require endoscopic therapy. Although balloon dilation with or without short-term stenting is recommended, long-term real-world outcome data remain limited. Materials and Methods: We retrospectively evaluated consecutive primary sclerosing cholangitis patients who underwent endoscopic retrograde cholangiopancreatography for dominant strictures between 2011 and 2023 at a tertiary referral center. All procedures were performed by a single experienced endoscopist. Interventions included endoscopic balloon or bougie dilation with subsequent short-term biliary drainage. The primary endpoint was recurrence-free survival at 24 months; secondary endpoints included clinical and biochemical response, disease progression, and safety outcomes. Results: Total of 35 patients (mean age 42.0 ± 13.5 years; 68.6% male) underwent 138 endoscopic procedures, with a median of three interventions per patient. Dilation was performed in 94.3% of cases, and all patients received short-term stenting or nasobiliary drainage (median duration 15 days). At three months, 78.8% of patients were asymptomatic and 80.0% achieved a ≥ 20% reduction in alkaline phosphatase. The 24-month recurrence-free survival rate was 45.4%. The overall complication rate was 8.0% (including cholangitis, pancreatitis, and stent migration), with no procedure-related mortality. Conclusion: Endoscopic management -particularly balloon dilation with short-term drainage- appears to be a safe and effective strategy for dominant strictures in primary sclerosing cholangitis, offering substantial short-term clinical and biochemical improvement with an acceptable safety profile. Nevertheless, the high recurrence rate highlights the chronic relapsing nature of the disease and emphasizes the need for structured long-term surveillance.

Background: Walled-off necrosis (WON) is a complex sequela of acute pancreatitis that often necessitates interventional management. Endoscopic transmural drainage has emerged as the preferred first-line approach, especially with the increasing availability of endoscopic ultrasonography (EUS) guidance. This study aimed to evaluate endoscopic management of WON and identify factors associated with technical and clinical success. Methods: Patients who underwent endoscopic transmural drainage for symptomatic WON were analyzed retrospectively. Two different techniques—conventional and EUS-guided—were used as endoscopic drainage modalities. Baseline characteristics, procedural details, and outcomes were collected, and the impact of drainage modality and anatomic factors—including paracolic extension, disconnected pancreatic duct syndrome (DPDS), and colonic fistula—on clinical outcomes and adverse events was analyzed. Results: A total of 73 patients (mean age: 54.6±13.9 y; 46.6% male) underwent a total of 76 transmural drainage procedures. The median size of WON collections was 14 cm (IQR: 11–17 cm), and the most common indication was infection (62.5%). Colonic fistula and DPDS were identified in 5 (6.8%) and 38 (52.1%) patients, respectively. Technical success was assessed per procedure. Overall technical success was 97.4% (74/76), with 100% (36/36) success in the conventional group and 95.0% (38/40) in the EUS group. Clinical success was achieved in 84.9% (62/73) of patients, with similar outcomes between conventional (83.3%) and EUS-guided (86.5%) drainage ( P =0.961). Reintervention was required in 67.1%, and direct endoscopic necrosectomy was performed in 31.5%. Complications occurred in 28.7% of patients, most commonly bleeding (15.1%), generally managed endoscopically. Conclusions: Endoscopic transmural drainage is an effective and safe intervention for the management of WON, with high technical and clinical success. EUS-guided drainage offers significant advantages by allowing intervention in patients without luminal bulging and in those with smaller collections, thereby expanding treatment eligibility to a broader patient population.