Hydatid cyst disease is a zoonotic disease caused by the transmission of Echinococcus granulosus, which is in the cestode class, to humans during the larval period. This disease causes serious problems by affecting public health and national economy as an important parasitic disease, especially in many developing countries. Liver cyst cysts can be complicated according to their diameter and location. Complication rate reaches 60%. The leading complications are bile duct involvement and related complications. Bile duct problems should be solved first in cysts associated with biliary tract. ERCP and endoscopic sphinterotomy can be performed. Here we discussed the treatment and management of a 35-year-old patient with hydatid cyst that opened into the biliary tract with ERCP, who presented to the emergency room with fever and signs of infection. Keywords:endoscopic cyst evacuation, cholangitis, endoscopic retrograde cholangiopancreatography

Background: Anastomotic leakage remains the most feared complication after colorectal cancer surgery, and reliable preoperative risk stratification is still evolving. The skeletal muscle index (SMI), derived from routine computed tomography, offers an objective, widely available measure of muscle mass. This study evaluated whether a low preoperative SMI predicts anastomotic leakage after colorectal cancer resection. Methods: We retrospectively screened 550 consecutive patients who underwent colorectal cancer resection with primary anastomosis at a single tertiary referral centre between 2018 and 2024, of whom 468 satisfied the eligibility criteria and formed the analytic cohort. Skeletal muscle area was measured on preoperative axial computed tomography at the third lumbar vertebra and normalised to the height squared to obtain the SMI. Anastomotic leakage was defined according to the International Study Group of Rectal Cancer criteria. Receiver operating characteristic analysis identified a single pragmatic SMI cut-off. Group comparisons used Mann–Whitney U and chi-square tests, and independent predictors were assessed by multivariable logistic regression. Results: Anastomotic leakage occurred in 33 of 468 patients (7.1%). Patients who developed leakage had a significantly lower mean SMI than those who did not (40.0 cm²/m² vs. 46.8 cm²/m², p = 0.005). An SMI below 48.6 cm2/m2 predicted leakage with 90.9% sensitivity, 38.2% specificity, and a 98.2% negative predictive value (area under the curve 0.646). Because specificity (38.2%) and positive predictive value (10.0%) were low, the index performed as a rule-out marker: a preserved SMI identified a low-risk subgroup, whereas a low-SMI had limited positive predictive value. The leakage rate reached 10.0% in the low SMI group versus 1.8% in the high-SMI group (p = 0.0008). Following multivariable analysis, low SMI was the only independent predictor of anastomotic leakage (adjusted odds ratio: 5.67, 95% confidence interval: 1.69 to 19.01, p = 0.005). Conclusions: A low preoperative SMI independently increased the odds of anastomotic leakage almost six-fold after colorectal cancer surgery, while its high negative predictive value identified a large group of patients at very low risk. Routine SMI assessment on existing staging computed tomography may strengthen preoperative risk stratification at no additional cost or radiation.

Amaç: Troid nodulleri dünya çapında oldukça yaygın bir patolojidir. Troıd ince iğne biopsisi(TİİAB) troid malignitelerinin tanısında oldukça önemli bir tanı aracıdır.Ancak sonuçları sınıflandırmak için kullanılan Bethesda Sistemi, hastalar önemi belirlenemeyen atipi/foliküler lezyon belirsiz öneme sahip (AUS / FLUS) nodulun bening veya malign olarak sınıflandıramamaktadır. Bu nedenle bu hastalarda en iyi tedavinin belirlenebilmesi için bazı risk faktörlerinin bilinmesi gerekmektedir. Bu çalışmamızda AUS/FLUS nedeniyle opere edilen hastalarımızı değerlendirmeyi amaçladık. Gereç ve yöntemler: Eylül 2018-Aralık 2021 tarihleri arasında TİİAB yapılan 1298 hastadan sitolojisi AUS/FLUS gelen ve opere edilen 144 hastayı retrospektif olarak inceledik. Bulgular: TİİAB yapılan sitolojisi AUS/FLUS gelen ve opere edilen 144 hastanın 58 (%40) inin histopatolojisi malign olarak geldi. Troid nodüllerinin ultrasound görüntü özelliklerini malıgn histopatoloji sonuçları ile karşılaştırdığımız zaman hipoekojen,mikrokalsifikasyon,düzensiz sınır ve hipervaskularite görüntülerinin malignite açısından ile anlamlı olduğu tesbit edildi(p