Multiple sclerosis (MS) is a chronic neuroinflammatory disease characterized by inflammation involving the peripheral nerves. Shear wave elastography (SWE) is potentially a method of choice for detecting peripheral nerve involvement. To compare the degree of thickening and nerve elasticity of brachial plexus (BP) nerve roots and evaluate the usefulness of sonoelastography in patients with clinically diagnosed MS without brachial plexopathy. Thirty-two patients with MS and 32 controls were included in the study. Bilateral C5, C6, and C7 mean nerve root diameters, and mean elasticity values in kiloPascal (kPa) were measured in the patient and control groups. The relationship between the age, height, and weight values and nerve diameter-elasticity values of the patient and control groups was compared. The elasticity values of the C5 and C6 nerve roots were increased, and the nerve root thickness was decreased in the MS group compared to that in the control (P < 0.05). There was no difference between the C7 mean nerve root elasticity (kPa) and diameter measurements in the patient and control groups (P > 0.05). Our study showed an increase in the BP nerve root elasticity values (kPa) in patients with MS compared to that of the control group and a decrease in diameter values thought to be related to the possible chronic atrophic process. The results are consistent with the demyelinating process of the peripheral nervous system (PNS) due to MS.

Intussusception is the invagination of the proximal intestinal segment into the distal portion. Reduction procedures with fluid or air have been used as the primary treatment of choice in clinically stable children. To evaluate the role of intestinal wall elasticity measurements by shear wave elastography (SWE) to predict the success of ultrasound-guided saline enema (USGSE) reduction. USGSE was performed, if not contraindicated otherwise, after the diagnosis of ileocecal intussusception via the ultrasound (US). The length and diameter of the intussusception and the median stiffness of the intestine were measured before USGSE. Seventeen children were diagnosed with ileocolic intussusception via grayscale US assessment. Two children whose SWE images became artifacts due to inadaptability were excluded from the study. Thus, the study involved 15 patients (9 boys, 6 girls; age range = 11–48 months). There was no statistically significant association between age and median stiffness measurement in kilopascal (kPa). (P > 0.05). A moderate positive correlation was observed between the median stiffness measurement (kPa) and the length of intussusception (r = 0.547; P = 0.035). There was no statistically significant relationship between median stiffness measurement (kPa) and short-axis diameter of intussusception (P > 0.05). Stiffness assessment of the intestinal wall in ileocolic intussusception during the US examination, which is the gold standard in the intussusception assessment, can be used as a new criterion for predicting the performance of the USGSE technique and might be useful in making decisions regarding the clinical management of ileocolic intussusception.

Aim: An azygos lobe is an unusual anatomical variation of the upper lobe of the right lung. During the formation of the lungs, the right azygos lobe develops as the precursor of the azygos vein, moving along the pleural surface rather than arcing forward above the origin of the lung to reach the upper vena cava, enters the apex of the right lung in the upper thoracic region. The purpose of this study was to assess the prevalence of the right azygos lobe in a sample of the Turkish population.Methods: This study was conducted from February to October 2020. Each computed tomography (CT) scan was checked for the presence of a right azygos lobe and a fissure on the axial plane. The azygos lobe was described as the convex line in the paramediastinal portion of the upper right lung on the CT scan. Our exclusion criteria were previous thoracic surgery in the right lung or parenchymal distortion on CT examinations.Results: One thousand nine hundred and sixty-five thorax CT scans were evalu¬ated retrospectively. Nine hundred and forty-five of them were from men and the remainder were from women. A total of 15 right azygos lobe variations were detected (six females, nine males). The mean age of the patients was 52.87 ± 14.604 years (30–77). The azygos lobe frequency was 0.76%.Conclusion: The azygos lobe is typically an uncommon variation of the right lung and is not really a distinct lobe. It is a very important variation that should be known about as it can mimic pathological conditions such as cysts, abscesses, or lung le¬sions. Since the azygos lobe is usually an incidental finding, radiologists and sur¬geons should be aware of this this potential anomaly during the imaging and inter¬ventional procedures.

OBJECTIVES: Establishing standard shear-wave elastography (SWE) values for healthy newborns can help distinguish normal conditions of the adrenal gland (AG) from pathological conditions. We aimed to establish a reference data set for AG stiffness values using SWE in healthy newborns. METHODS: The quantitative stiffness of the AG was measured in the coronal plane in kilopascal (kPa). The quantitative descriptive statistics were presented as mean with standard deviation and median with range. The relationship between the quantitative variables was calculated using "Spearman's rank correlation coefficient test." The intraclass correlation coefficient (ICC) test was used to analyze intraobserver reliability. A p-value 0.05 was considered statistically significant. RESULTS: A total of 120 AGs of 60 healthy newborns (30 females and 30 males) was examined. The mean stiffness values of the right AG for the first and second visits were 7.51 +/- 2.45 and 7.54 +/- 2.49 kPa, respectively, and those of the left AG for the first and second visits were 7.60 +/- 2.03 and 7.42 +/- 1.97 kPa, respectively. There was no statistically significant difference between the mean values of adrenal stiffness and the length and width of AG and weight, height, and age (p 0.05). The ICC values for mean stiffness values of each AG were >0.80-0.90, indicating good intraobserver agreement. CONCLUSIONS: This study is the first SWE study to evaluate the AG in healthy newborns. Our study's data can be used as a reference for future research.

Background/Aims: Gastric outlet obstruction (GOO) is a rare condition in childhood, with the exception of infantile hypertrophic pyloric stenosis (IHPS). However, no classification exists from a pediatric gastroenterologists perspective. Materials and Methods: The patients with a diagnosis of GOO between 2009 and 2020 were reviewed retrospectively. We classified the patients according to GOO: presence of clinical findings accompanied by radiological and/or endoscopic findings; clinical status: intractable nonbilious postprandial vomiting alone or with abdominal pain, early satiety, weight loss, postprandial abdominal distension, and malnutrition; radiology: delayed gastric emptying and dilated stomach; endoscopy: nonbilious gastric contents after 6-8 hours of emptying and/or failed pyloric intubation; physical examination: visible gastric peristalsis. Results: A total of 30 GOO patients (15 patients with IHPS, 1 patient with annular pancreas, 4 patients with gastric volvulus, 2 patients with duodenal atresia, 2 patients with antral web, 1 patient with late-onset hypertrophic pyloric stenosis (LHPS) had surgical treatment, and remaining 5 patients had medical treatment) were enrolled to the study. The median age was 8 months (range: 3 months-16 years), and 14 patients were female. Mitochondrial disorders, LHPS, metabolic disorders, and eosinophilic gastrointestinal system diseases were added to Sharmas GOO classification, and the classification has been expanded. Conclusion: This is the first and largest study of GOO in children. From the perspective of pediatric gastroenterology, new diseases will be addressed, and definitions will be highlighted with our classification for GOO in childhood. Cite this article as: Eğritaş Grkan ö, öztrk H, Kaya C, et al. A classification for gastric outlet obstruction in childhood: Extending beyond infantile hypertrophic pyloric stenosis. Turk J Gastroenterol. 2024;35(3):255-261.