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Cancer antigen 19-9 is a tumor marker present at high levels in the bileduct, colorectal, gastric, and hepatocellular cancer than esophagus orpancreas cancer. It is used to confirm the diagnosis of pancreas cancer,to assess the clinical response to the treatment, and to evaluate therecurrence of pancreatic cancer. High levels can also be seen in benignconditions, such as biliary tract obstruction, cholangitis, inflammatorybowel disease, acute or chronic pancreatitis, liver cirrhosis, cystic fibrosis,or thyroid diseases. Another rare condition which is associated withthe high level of cancer antigen 19-9 is the splenic cyst. Hence, weare submitting this case report of splenic cyst because of its rarenessand similarities to previously published cases with high levels of cancerantigen 19-9., CA 19-9 safra kanalı, kolon, mide, over, hepatosellüler, özofagus vepankreas kanserleri gibi malign durumlarda yüksek seviyelerde görülebilenbir tümör göstergesidir. Pankreas kanseri ayırıcı tanısı ve yinepankreas kanserinde tedaviye cevap ve nüksün değerlendirilmesindekullanılır. Yüksek seviyeler safra yolu obstrüksiyonu, kolanjit, inflamatuvarbarsak hastalığı, akut veya kronik pankreatit, karaciğer sirozu, kistikfibrozis ve tiroid hastalıkları gibi benign durumlarda da görülebilir. CA19- yüksekliği ile birlikte olan nadir bir durum da dalak kistleridir. Olgumuznadir olması ve CA 19-9‘un yayınlanılan benzer olgulardan yüksekseviyelerde olması sebebiyle sunulmuştur.

A Rare Etiology of Acute Abdomen Syndrome: Perforation of The Small Intestinal Lymphoma Akut Batın Sendromunun Nadir Bir Etyolojisi: İnce Barsak Lenfoma Perforasyonu Fatih Altıntoprak, Enis Dikicier, Yusuf Yürümez, Osman Nuri Dilek

Background/Aims: To evaluate the association between insulin resistance and hepatic fibrosis in patients with chronic hepatitis C.Materials and Methods: A total of 104 chronic hepatitis C patients were included in this non-interventional, openlabel, observational, multicenter, cross-sectional study conducted at 20 gastroenterology clinics in Turkey. The primary end point was the correlation between stage of hepatic fibrosis and insulin resistance evaluated via the homeostasis model of assessment-insulin resistance index. Confounders of hepatic fibrosis and insulin resistance were the secondary end points. Results: The mean age of patients was 52.8 years; 65.4% were female. Type 2 diabetes was present in 6.8% and insulin resistance noted in 38.0% of patients. Further, 45.7% of the patients had mild (A0/A1) and the remaining had moderate/severe (A2/A3) hepatic necroinflammatory activity. Patient distribution according to Metavir fibrosis stage was as follows: F0/F1 (57.0%); F2 (6.5%); F3 (23.7%); and F4 (12.9%). A univariate analysis revealed significant positive correlations between Metavir fibrosis stage and insulin resistance (r=0.297; p=0.007). Logistic regression analysis showed that significant predictors of insulin resistance were high alanine transaminase levels (odds ratio, 0.97; 95% confidence interval, 0.944-0.997) and liver fibrosis stage (odds ratio, 0.114; 95% confidence interval, 0.0210.607).Conclusion: Our findings revealed significant associations between insulin resistance and hepatic fibrosis.

Chanarin-Dorfman syndrome is a rare, inherited metabolic disorder of neutral lipid storage characterized by ichthyosis, lipid vacuoles in leukocytes, and involvement of several internal organs, mostly the liver. Since the initial case was reported by Dorfman in 1974, nearly 50 cases have been reported, and the majority were from Middle East countries. Here, we report a 20-year-old patient with ichthyosis from Turkey, diagnosed as Chanarin-Dorfman syndrome presented with asypmtomatic elevated transaminases and hepatosteatosis, and also briefly review the updated clinical implications and management of this rarely seen syndrome. Prompt diagnosis of this syndrome avoids further unnecessary investigations in patients with ichthyosis