IntroductionLaparoscopic cholecystectomy has become the gold standard for the surgical treatment of gallbladder disease. Severe inflammation makes laparoscopic dissection technically more demanding in acute cholecystitis. Conversion to open cholecystectomy due to adverse conditions is still required in some patients.AimTo evaluate predictive risk factors associated with conversion to open cholecystectomy in acute cholecystitis.Material and methodsA retrospective analysis was performed on 165 patients who underwent a laparoscopic cholecystectomy for acute cholecystitis in our clinic. Patients who completed laparoscopic cholecystectomy and required conversion to open cholecystectomy were compared in terms of age, sex, fever, laboratory and USG findings, operation timing, complications, and duration of hospital stay.ResultsThere were 53 (32%) male and 112 (68%) female patients; the mean age was 52.4 ±12.5 years. Forty-six (27.9%) of the 165 patients were converted to open cholecystectomy. Male sex of the patients who underwent conversion (47.1%) was found to be statistically significant (p < 0.001). Preoperative white blood count, blood glucose and amylase values, morbidity rate, and hospital stay were raised in patients who underwent conversion, and all were found to be statistically significant (p < 0.05).ConclusionsMale sex, blood leucocyte, glucose, and raised amylase emerged as the effective factors for conversion cholecystectomy in our study. These factors should help the clinical decision-making process when planning laparoscopic cholecystectomy in acute cholecystitis. By predicting these risk factors for conversion, preoperative patient counselling can be improved.

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IntroductionAn aneurysmal bone cyst is a benign, but expansile tumor like lesion that generally occurs in the long bones including the vertebral column. An aneurysmal bone cyst arising from the rib, especially in the elderly, is extremely rare.Case presentationWe report a 58-year-old Turkish woman with an aneurysmal bone cyst of the right 3rd rib treated with chest wall resection. The pathologic findings confirmed the diagnosis of aneurysmal bone cyst. The patient has been followed up for 5 years with no evidence of recurrence.ConclusionEn bloc resection can be curative and provide good results for this rare type of chest wall tumor.

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Aim. Constipation is one of the most common complaints of the digestive system indicated with an increase in defecation frequency, difficulty in defecation, and hard and strained defecation. Environmental, personal, and genetic factors may be affecting constipation although the affecting factors have not yet been thoroughly explained. The aim of this study was to investigate constipation frequency and lifestyles in medical students. Method. The population was selected among medical students for the study, which was planned as a survey study. Demographic data of all the participants and the factors suggested to affect constipation were questioned and analyzed. Results. The study covered a total of 425 medical students. Among the students reporting constipation, 2.86% were in their first year of medical school, while 7.53% were in the third year and 9.09% were in the sixth year. The rate of students reporting constipation and familial history was statistically significant. While regular eating habits were reported in the first and third years, this rate was much lower in the sixth year group working at clinical departments. The results of our study did not reveal any significant relationship between daily intake of water and constipation. There was, however, a significant relationship between stress and constipation. Conclusion. The results of our study showed that medical education did not curb constipation frequency. We believe that stress is significant in constipation. The data we collected indicate that regular eating habits and excess liquid intake are not as effective as suggested in the treatment of constipation.

ObjectivesGastorenteropancreatic neuroendocrine (GEP-NET) tumors are the second most common tumors of the gastrointestinal tract. We aimed to investigate the clinicopathological features and factors affecting the prognosis of patients with GEP-NET.MethodsClinicopathological features of 158 patients were evaluated, including tumor location, TNM stage and grade, pathological features, presence of lymph nodes and distant metastases at the time of diagnosis, maximum tumor diameter and treatment details. Also, follow-up information was analyzed to discover possible prognostic factors.ResultsThe most common primary site is pancreas (45.6%, n = 72). Most of the GEP-NETs were nonfunctional (93.6%, n = 148). Of the 158 patients, 94 (59.5%) were grade 1, 46 (29.1%) grade 2, and 18 (11.4%) grade 3. The 1-year, 3-year, and 5-year survival rates were 82.3% (130/158), 61.4% (70/114), and 47.2% (35/74), respectively. In multivariate analysis, histological grade (P = 0.04) and TNM stage (P < 0.001) were independent prognostic factors for survival in patients with GEP-NET.ConclusionsThey are increasing in frequency and are the most common tumors in the pancreas. Nonfunctional tumors made up the majority of cases. The main treatment was surgical resection. Histological grade and TNM stage are independent prognostic factors.

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Introduction. Coronavirus 2019 disease (COVID-19), caused by the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), has spread to more than 200 countries worldwide. We aimed to present acute pancreatitis (AP) cases caused by SARS-CoV-2 viral infection. Methods. The study was conducted retrospectively between April 2020 and June 2020 in Necmettin Erbakan University Meram, Medical Faculty Hospital, and 150 hospitalized patients diagnosed with COVID-19 were included. The degree of acute pancreatitis was determined according to the Atlanta classification. Organ failures of the patients were evaluated in terms of respiratory, cardiovascular, and nephrology according to the modified Marshall scoring (MMS) system, and CTSI (Balthazar score) and Imrie score were determined. Modified   Marshall   score ≥ 2 was considered organ failure. Results. A total of 29 patients were diagnosed with acute pancreatitis. All 29 patients with pancreatitis had respiratory failure during hospitalization. After the diagnosis of pancreatitis, there was no change in respiratory failure. According to the Atlanta classification, 19 patients had mild AP and 10 patients had moderate AP. Patients with acute pancreatitis were scored according to the CTSI (Balthazar score), and there were no patients with ≥6 severe pancreatitis. The CTSI score of 4 patients was 3. In addition, the Imrie score of the patients was determined and 8 patients with Imrie   score ≥ 3 were identified. Conclusion. The rate of pancreatic damage in SARS-CoV-2 infection was found to be 19% ( n = 29 ) in our study. In our study, we highlight acute pancreatitis as a complication associated with COVID-19 and the importance of pancreatic evaluation in patients with COVID-19 and abdominal pain is demonstrated.