A case of hepatic portal venous gas after colonoscopy.

Hepatic portal venous gas (HPVG) is a rare radiologic finding that is usually precipitated by intestinal ischaemia, intra-abdominal abscesses, necrotising enterocolitis, abdominal trauma, infectious enteritis, and inflammatory bowel disease. In this study, we present a case of HPVG in a 66-year-old female patient who underwent colonoscopy for evaluation of haematochezia and a review of the literature focused on HPVG following colonoscopy.

Risk Factors for Polyautoimmunity among Patients with Celiac Disease: A Cross-Sectional Survey.

AIM: To define the prevalence of polyautoimmunity (PAI) among celiac disease (CD) patients and to compare clinical and laboratory features of CD patients with or without PAI in order to determine the risk factors for PAI in CD. MATERIAL AND METHOD: Patients diagnosed with CD in our clinic between 2007 and 2014 with at least 1 year of follow-up were retrospectively evaluated. Totally 145 patients were included in the study. Information on patient demographics and laboratory data were obtained from patient records. The study participants were divided into 2 groups. Group 1 was the CD-alone group consisting of patients without any other autoimmune diseases (AIDs), while group 2 was the PAI group consisting of patients with accompanying one or more AIDs. RESULTS: The mean age of 145 CD patients (106 female and 39 male) included in the study was 37.2 ± 12.3 years. Of the 145 patients included, 48 (33.1%) were in the PAI group. When two groups were compared with each other in terms of the demographic features and laboratory data, the following were identified as risk factors for PAI: female gender, family history for AIDs, antigliadin IgG positivity, vitamin D deficiency, antinuclear antibody positivity ≥1/80 titer and having any musculoskeletal disease. CONCLUSION: To the best of our knowledge, this is one of the largest studies in the literature on CD patients for the PAI prevalence and related risk factors. Identification of the risk factors in early stages is important to explore PAI among CD patients. Larger, prospective studies are warranted about the risk factors and autoimmune characteristics of CD.

Analysis of 2222 colorectal polyps in 896 patients: a tertiary referreal hospital study.

BACKGROUND/AIMS: In Turkey, there are a limited number of studies including the characteristics of colorectal polyps, and the number of patients was too small in most of them. The aim of this study was to evaluate histological characteristics of colorectal polyps that were determined by colonoscopy and clinical features of patients who had removal of the polyp. MATERIALS AND METHODS: Patients who underwent colonoscopy were analyzed retrospectively from January 2007 to December 2011. Adult patients (≥18 years) with no history of previous colorectal neoplasms who had removal of colorectal polyp were included. RESULTS: A total of 2222 colorectal polyps were removed in 896 patients. Of these, 621 were male (69.3%) and 275 were female (30.7%). Most of the patients with polyps presented in the age group of 50-59 years (251 patients, 28%). It was recorded that 1816 (81.7%) of all polyps were adenomas. Of 1816 adenomas, 1577 (86.8%) were tubular adenomas. Of patients with adenomas, 19.7% was younger than 50 years. A total of 337 (37.6%) patients were in the high-risk group. Mean age of the high-risk patients was higher than the others (62±13 years and 58±13 years, respectively, p=0.001). CONCLUSION: This study is the largest series of colorectal polyps in Turkey to date. We determined the clinical and histologic characteristics of colorectal polyps and consider that the detection rate of colorectal adenomas in patients under the age of 50 years may be increased by the widespread use of colonoscopy as a diagnostic test.

Impact of anti-aggregant, anti-coagulant and non-steroidal anti-inflammatory drugs on hospital outcomes in patients with peptic ulcer bleeding.

BACKGROUND/AIMS: There are a limited number of studies including the impact of antiplatelet drugs use on hospital outcomes for nonvariceal upper gastrointestinal bleeding. The aim of this study was to determine the effect of anti-aggregant, anti-coagulant and non-steroidal anti-inflammatory drugs upon hospital outcomes in patients with peptic ulcer bleeding. MATERIALS AND METHODS: The patients under treatment with antiaggregant, anticoagulant or non-steroidal anti-inflammatory drugs were categorized as exposed group (n = 118) and the patients who were not taking any of these drugs were categorized as non-exposed group (n = 81). We analyzed the data of drug intake, comorbid disease, blood transfusion, duration of hospital stay, Blatchford/total Rockall score and diagnosis of patients. RESULTS: In total, 199 patients were included. Of these 59.3% (exposed group) were taking drugs. The patients in exposed group were significantly older than those in non-exposed group (62.9 ± 17.3 years; 55.5 ± 19.3 years, P = 0.005, respectively). Mean number of red blood cell units transfused (2.21 ± 1.51; 2.05 ± 1.87, P = 0.5), duration of hospital stay (3.46 ± 2.80 days; 3.20 ± 2.30 days, P = 0.532) and gastric ulcer rate (33% vs 23.4%, P = 0.172) were higher in exposed group than in non-exposed group but the differences were not statistically significant. Total Rockall and Blatchford scores of the patients were significantly higher in exposed group than in non-exposed group (3.46 ± 1.72 vs 2.94 ± 1.87, P = 0.045; 10.29 ± 3.15 vs 9.31 ± 3.40, P = 0.038). CONCLUSION: Our study has shown that anticoagulants, antiaggregants and nonsteroidal anti-inflammatory drugs do not effect duration of hospital stay, red blood cell transfusion requirement and rebleeding for peptic ulcer bleeding.

Evaluation of serum ghrelin levels in patients with hyperplastic gastric polyps.

BACKGROUND/AIMS: Ghrelin is a 28 amino acid peptide and the main source of serum ghrelin is the stomach. The aim of this study was to evaluate serum ghrelin levels in patients with hyperplastic gastric polyp. MATERIALS AND METHODS: Eighty patients (50 female, 30 male) were included in this study: 28 with hyperplastic gastric polyp, 20 with benign gastric ulcer and 32 with chronic active gastritis. Serum ghrelin levels were measured by radioimmunoassay method. RESULTS: Serum ghrelin level was significantly lower in patients with hyperplastic gastric polyp (1139.86 ± 279.23 pg/ml) than in those with benign gastric ulcer (1362.45 ± 335.35 pg/ml) and chronic active gastritis (1362.91 ± 269.67 pg/ml) (p=0.016 and p=0.003, respectively). The benign gastric ulcer and chronic active gastritis groups had similar serum values (p=0.996). Serum ghrelin level was not affected by Helicobacter pylori, with levels of 1298.70 ± 309.01 pg/ml and 1252.12 ± 303.04 pg/ml in 56 positive and 24 negative patients, respectively (p=0.536). In the patients with hyperplastic gastric polyp, Helicobacter pylori infection was found to have no effect on serum ghrelin level (p=0.855). CONCLUSIONS: Serum ghrelin levels of patients with hyperplastic gastric polyp were lower than in patients with benign gastric ulcer and chronic active gastritis. In patients with various benign stomach lesions, the presence of Helicobacter pylori does not seem to affect serum ghrelin levels.

Capsule endoscopy findings in celiac disease.

Capsule endoscopy (CE) is a noninvasive imaging method used to evaluate intestinal mucosa. We aimed to examine intestinal mucosal changes in celiac disease (CD) with CE. Eight untreated patients who had anti-endomysial antibody-positive duodenal biopsy results consistent with CD were included in the study. Villous atrophy, scalloping, fissuring, and mosaic pattern (consistent with CD) were detected in seven patients; one patient was excluded for early meal consumption. No patchy involvement was found in the intestine or distal region of the intestine (ileum) in any of the patients. The common feature of all patients was that villous atrophy, scalloping, fissuring, and mosaic patterns detected in the proximal intestine gradually decreased towards the distal intestine. CE provided no diagnostic contribution to CD when compared with duodenal biopsy. It can be used to show villous atrophy in selected cases and to evaluate the extension of intestinal involvement in CD.