Background/Aims: Primary biliary cholangitis (PBC) is a chronic liver disease influenced by environmental, genetic, and epigenetic fac tors, with varying incidence across populations. This study compared demographic, biochemical, and treatment responses in Danish and Turkish PBC patients. Materials and Methods: Four cohorts were analyzed: (1) 101 incident Turkish patients, (2) 77 incident Danish patients, (3) 103 prevalent Turkish patients, and (4) 155 prevalent Danish patients. Demographics, biochemical data, disease severity, and response to ursodeoxy cholic acid (UDCA) were assessed. Regression analysis was applied to the entire cohort to identify factors associated with the UDCA response. Results: Female dominance was noted in all cohorts (>90%) except the Danish incident group (75%). Turkish patients in the preva lent cohort were younger than Danish patients. Antimitochondrial antibody (AMA) positivity was higher in Turkish cohorts (92%-97%) compared to Danish cohorts (75%-88%). Biochemical data were similar across groups, with 15% of both populations having cirrhosis. Turkish patients showed a higher complete response to UDCA. Elevated alanine aminotransferase (ALT) levels reduced UDCA response, while Turkish ethnicity and older age improved it. Conclusion: Despite similar disease severity and age at diagnosis between Danish and Turkish PBC patients, Turkish patients had higher AMA positivity and better responses to UDCA treatment. These findings suggest potential genetic or environmental influences on treat ment efficacy. Cite this article as: Eruzun H, Bossen L, Turan Gökçe D, et al. Clinical and biochemical characteristics of a Danish and Turkish cohort of incident and prevalent patients with primary biliary cholangitis. Turk J Gastroenterol. 2025;36(4):241-246.

Background and Objectives: Acute pancreatitis (AP) is an acute inflammatory disease ranging from mild, self-limiting forms to severe presentations associated with high morbidity and mortality. Early prognostic assessment is crucial for guiding clinical management. This study aimed to evaluate the prognostic value of the red cell distribution width-to-albumin ratio (RDW/Alb, RAR) in relation to clinically relevant outcomes, including intensive care unit (ICU) admission and in-hospital mortality, in patients with AP. Materials and Methods: This retrospective study included 282 patients diagnosed with AP who were hospitalized at Mersin University Hospital between January 2019 and February 2024. Clinical, laboratory, and radiological data were retrospectively analyzed. The predictive performance of RAR was evaluated and compared with established clinical scoring systems, including bedside index for severity in acute pancreatitis (BISAP), systemic inflammatory response syndrome (SIRS), harmless acute pancreatitis score (HAPS), and pancreatitis activity scoring system (PASS). Results: The median RDW-to-albumin ratio (RAR) was 3.9 (range: 2.6–36.7). Receiver operating characteristic (ROC) curve analysis demonstrated that RAR showed good predictive performance for ICU admission (Area Under the Curve (AUC): 0.781; p < 0.001; optimal cut-off: 4.15) and high predictive performance for in-hospital mortality (AUC: 0.927; p < 0.001; optimal cut-off: 5.26). RAR exhibited limited but statistically significant discriminatory performance when compared with the BISAP score (AUC: 0.591; p = 0.017), whereas no significant predictive performance was observed in relation to PASS, HAPS, or SIRS scores. Conclusions: Within the context of this retrospective cohort, RAR is a simple, inexpensive, and readily available biomarker that may be associated with ICU admission and in-hospital mortality in patients with AP. Given the absence of standard severity endpoints such as persistent organ failure or pancreatic necrosis, these findings should not be interpreted as evidence of conventional disease severity prediction but rather as hypothesis-generating observations that warrant validation in larger prospective studies.

Background/Aims: De novo malignancies are an important long-term complication following liver transplantation (LT), driven bychronic immunosuppression and extended post-transplant survival. Understanding patterns by tumor type, timing, and patient characteristics is essential for optimized surveillance. This study aimed to evaluate the clinical characteristics and temporal trends of de novoneoplasms in LT recipients.Materials and Methods: A total of 6943 adult LT recipients from 16 Turkish centers were evaluated between 1999 and 2023). Two hundred eight patients with 220 histologically confirmed de novo malignancies (excluding hepatocellular carcinoma) were included. Patientswho died within 30 days or developed cancer within 90 days post-LT were excluded. Incidence and mortality rates were assessed acrosspost-transplant intervals.Results: Non-skin solid (53.2%), dermatologic (28.6%), and hematologic (18.2%) cancers were predominant. Most malignancies (76.8%)occurred within 10 years post-LT. Early-onset (<10 years) malignancies were more common in living donor recipients (62.7%, P = .001)and associated with higher mortality (39.6% vs. 11.8%, P < .001). Recipients ≤60 years exhibited a higher incidence of hematologiccancers (23.9% vs. 12.6%, P = .03) and increased mortality (39.4% vs. 27.0%, P = .05). In subgroup analysis, tacrolimus use was stronglyassociated with cutaneous squamous cell carcinoma (P = .004). Peak incidence occurred 2-10 years post-LT (≈13-14 per 1000 recipients), with non-skin solid tumors being the most frequent.Conclusion: De novo malignancies remain a significant long-term risk after LT, with outcomes influenced by tumor type, age, immunosuppression, and timing of onset. Risk-adapted surveillance and tailored oncologic management, particularly dermatologic screeningin tacrolimus-treated patients and enhanced surveillance during the 2-10 year post-transplant period are recommended to improvelong-term survival.Cite this article as: Danış N, Döngelli H, Ünek T, et al. De novo malignancies after liver transplantation: A multicenter cohort studyof incidence, timing, and outcomes. Turk J Gastroenterol. Published online February 20, 2026. doi:10.5152/tjg.2026.25748.

Cite this article as: Harput ZN, Sezgin O, Apaydın FD, Reyhan E. Abdominal cocoon syndrome: A rare condition that causes diagnostic challenges. Turk J Gastroenterol. Published online May 4, 2026. doi: 10.5152/tjg.2026.25642.

Kemoterapi, kanser tedavisinde etkin bir yöntem olmasına rağmen, sağlıklı hücreleri de etkileyerek önemli yan etkilere yol açar. Gastrointestinal sistemde bulantı, kusma, ishal, kabızlık, mukozit ve tat değişiklikleri gibi semptomlar ortaya çıkabilirken, karaciğer üzerinde toksisiteye bağlı fonksiyon bozuklukları gelişebilir. Bu yan etkilerin yönetimi, hastaların tedaviye uyumunu artırmak ve yaşam kalitesini korumak için kritik öneme sahiptir. Destekleyici tedaviler ve kişiselleştirilmiş yaklaşımlar, kemoterapiye bağlı komplikasyonları en aza indirmek için uygulanmalıdır.

Giriş ve Amaç: Transpankreatik sfinkterotomi, endoskopik retrograd kolanjiyopankreatografi sırasında biliyer kanülasyonun başarısız olduğu durumlarda, ortak safra kanalına erişim sağlamak amacıyla uygulanan ileri bir kanülasyon tekniğidir. Bu prosedür, sfinkterotom aracılığıyla pankreas ve safra kanalı arasındaki septumun kesilmesini içerir. Çalışmamızda, transpankreatik sfinkterotominin etkinlik ve güvenliğini, post-endoskopik retrograd kolanjiyopankreatografi pankreatiti ile diğer olası komplikasyonlar açısından klinik sonuçlarını değerlendirdik. Gereç ve Yöntem: 1 Şubat 2020 – 1 Eylül 2023 tarihleri arasında Mersin Üniversitesi Hastanesi'nde gerçekleştirilen endoskopik retrograd kolanjiyopankreatografi işlemleri retrospektif olarak incelendi. Çalışma grubu, ardışık olarak transpankreatik sfinkterotomi uygulanan 66 hasta ile 67 kişilik kontrol grubundan oluşmaktaydı. Veriler, hasta dosyaları ve hastane kayıtlarından elde edildi. Hastaların demografik özellikleri, biliyer kanülasyon başarı oranı, endoskopik retrograd kolanjiyopankreatografi sırasında gerçekleştirilen işlemler, işlem sonrası pankreatit gelişimi, diğer komplikasyonlar ve ilişkili risk faktörleri değerlendirildi. Bulgular: Transpankreatik sfinkterotomi grubunda 29 hastada (%43.9) post-endoskopik retrograd kolanjiyopankreatografi pankreatiti gelişirken, kontrol grubunda bu oran 10 hastada (%14.9) saptanmış ve fark istatistiksel olarak anlamlı bulunmuştur (p < 0.001). Hiperamilazemi oranı her iki grupta da %23.9 olup transpankreatik sfinkterotomi uygulamasıyla anlamlı ilişki göstermemiştir (p = 0.80). Kanama insidansı açısından da gruplar arasında fark izlenmemiştir (p = 0.55). Transpankreatik sfinkterotomi uygulaması ile diabetes mellitus, hipertansiyon, hiperlipidemi, kardiyovasküler hastalık, kronik böbrek yetmezliği, kronik obstrüktif akciğer hastalığı ve kolesistektomi öyküsü arasında anlamlı bir ilişki saptanmamıştır (sırasıyla p = 0.37; 0.06; 0.99; 0.39; 0.32; 0.15; 0.12). Ortalama hastanede yatış süresi transpankreatik sfinkterotomi grubunda 6.9 ± 3.8 gün, kontrol grubunda ise 3.7 ± 2.3 gün olup fark anlamlıdır (p = 0.008). Ayrıca transpankreatik sfinkterotomi uygulanan hastalarda post-prosedürel karın ağrısı daha şiddetli izlenmiştir (p < 0.001). Sonuç: Transpankreatik sfinkterotomi yöntemi kanülasyon başarısını artıran bir yöntemdir. Diğer taraftan transpankreatik sfinkterotomi yönteminin faydalı ancak post endoskopik retrograd kolanjiyopankreatografi pankreatiti açısından yeterince güvenli olmadığını düşünüyoruz.