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Aim: The incidence of hepatitis A (HepA) has decreased due to vaccination and improved hygiene conditions. However, the age of onset of the disease has shifted from childhood to adulthood. Children with HepA are mildly symptomatic, whereas the course of the disease in adults may be severe. The aim of this study was to examine the change in HepA seroprevalence and identify the population susceptible to HepA.Material and Methods: A total of 10132 patients who were tested anti-Hepatitis A virus immunoglobulin G (anti-HAV IgG) between 2016 and 2019 were reviewed retrospectively, and included in this study. The patients were divided into five groups according to their age, and seropositivity rates were compared between age groups. The relevant data of the healthcare professionals were also evaluated separately.Results: The overall seropositivity rate was 60.1% (n=6088). The seropositivity rate was found 29.0% (n=944) in the 18 to 24 years range, 49.7% (n=837) in the 25 to 29 years range, 60.6% (n=689) in the 30 to 34 years range, 76.6% (n=784) in the 35 to 39 years range, and 93.3% (n=2834) in the ≥40 years groups. The seropositivity rate was found 36.1% (n=1781) and 82.9% (n=4307) in patients, Amaç: Aşılama ve hijyen koşullarının iyileşmesi sayesinde hepatit A (HepA) insidansı azalmıştır. Bununla birlikte, hastalığın başlangıç yaşı çocukluk çağından yetişkinlik çağına doğru kaymıştır. HepA olan çocuklar hafif semptomatik iken erişkinlerde ise hastalığın seyri şiddetli olabilir. Bu çalışmanın amacı, HepA seroprevalansındaki değişimi incelemek ve HepA'ya duyarlı olan popülasyonu belirlemektir.Gereç ve Yöntemler: Bu çalışmada, 2016 ve 2019 yılları arasında anti-Hepatit A virüsü immünoglobulin G (anti-HAV IgG) testi çalışılmış olan toplam 10132 hastanın verileri geriye dönük olarak incelendi ve çalışmaya dahil edildi. Hastalar yaşlarına göre beş gruba ayrıldı ve bu yaş grupları arasında seropozitiflik oranları karşılaştırıldı. Sağlık çalışanlarının ilgili verileri de ayrıca değerlendirildi.Bulgular: Genel seropozitiflik oranı %60,1 (n=6088) idi. Seropozitiflik oranı 18 ile 24 yaş aralığında %29,0 (n=944) olarak, 25 ile 29 yaş aralığında %49,6 (n=837) olarak, 30 ile 34 yaş aralığında %60,6 (n=689) olarak, 35 ile 39 yaş aralığında %76,6 (n=784) olarak ve ≥40 yaş grubunda %93,3 (n=2834) olarak bulundu. Seropozitiflik oranı

Intestinal tuberculosis is an uncommon form of tuberculosis, and its diagnosis remains a challenge in patients with Crohn's disease. The clinical, endoscopic, radiologic, and histologic features of Crohn's disease and tuberculosis are remarkably similar, posing a diagnostic challenge. Accurate diagnosis of these two conditions remains vital to the decision on the treatment of the patients. Computerized tomography, endoscopic ultrasound (EUS), capsule endoscopy, balloon enteroscopy, ascitic fluid adenosine deaminase (ADA), tuberculosis polymerase chain reaction (TB-PCR), GeneXpert MTB/RIF assay (Cepheid, Sunnyvale, CA), and laparoscopy can be beneficial in the diagnosis of intestinal tuberculosis. Herein, we report a case where tuberculosis could not be documented, although the patient displayed lymphocytosis in ascites and weight loss. Laparoscopy was diagnostic and the patient benefited from the correct treatment.

Celal Ulasoglu,1 Zeynep Nilufer Tekin,2 Kubra Akan,1 Arda Yavuz1 1Department of Gastroenterology, Medeniyet University, Goztepe Education and Research Hospital, Istanbul, Turkey; 2Department of Radiology, Medeniyet University, Goztepe Education and Research Hospital, Istanbul, TurkeyCorrespondence: Celal UlasogluDepartment of Gastroenterology, Medeniyet University, Goztepe Education and Research Hospital, Istanbul, TurkeyTel +90 216 5666600Fax +90 216 6065210Email ulasoglu@gmail.comPurpose: To identify the correlation of nonalcoholic pancreatic steatosis (NAPS) with nonalcoholic fatty liver disease (NAFLD) in an outpatient group. Based on its metabolic and imaging properties, NAPS has been increasingly recognized in recent years; however, its interaction with NAFLD is still not clear.Patients and Methods: In this cross-sectional observational study, 345 consecutive patients without any chronic illness who were referred to the senior radiologist for abdominal ultrasound (US) were included. The US report showed hepatic and pancreatic echogenicity. The patients’ demographic, anthropometric, and laboratory data were collected from medical records.Results: Overall, NAPS and NAFLD were seen in 227 (65.8%) and 219 (63.5%) patients, respectively. Normal echogenicity was noted in 74 (21.4%) patients. Forty-four patients (12.8%) had steatotic liver without NAPS, 52 (15.1%) had steatotic pancreas without NAFLD, and 175 (50.7%) had steatosis in both organs. The discordance in steatosis grading between NAPS and NAFLD was 55.1%. Insulin resistance was present in 8.7, 26.7, 19, and 61.3% of patients with no steatosis, only NAFLD, only NAPS, and steatosis in both organs, respectively. Evident NAFLD and NAPS having grade 2 and 3 steatosis were present in 15.3% and 29.0% of the study group, respectively. Cholecystolithiasis was present in 6.8, 13.6, and 28.8% of patients with normal echogenic pancreas, only NAFLD, and only NAPS, respectively (p=0.01).Conclusion: Based on the ultrasonographic, clinical, demographic, and anthropometric features of the included patients, we found that NAPS did not fully accompany nonalcoholic fatty liver. Despite severe pancreatic steatosis, more than a quarter of cases had normal liver echogenicity. Insulin resistance frequency was insignificantly higher in NAFLD than NAPS (p=0.694). The significantly higher frequency of cholecystolithiasis in NAPS needs further large-scale studies. The inconsistency of steatosis degree in NAPS and NAFLD in > 50% cases may reflect differences in the pathophysiology of these two clinical entities.Keywords: nonalcoholic pancreatic steatosis, nonalcoholic fatty liver disease, insulin resistance, ultrasound

Surgeries for obesity can lead to complications. Dumping syndrome is one such complication caused by the quick passage of hyperosmolar chyme from the stomach to the duodenum. Mild cases can be cured with dietary modification and medical treatment. However, refractory cases may need invasive treatment options, such as transoral outlet reduction or surgery. We successfully treated a 48-year-old female with dumping syndrome, using a combination of argon plasma coagulation and hemoclips to narrow the pyloric lumen. We suggest that this new technique could be a cheap and easily accessible alternative to surgery, especially in countries where the specialised devices needed to treat such cases are unavailable.