Şehmus Ölmez

Sleep Apnea and Fatty Liver Are Coupled Via Energy Metabolism

Background Obstructive sleep apnea (OSA) is a common sleep-related breathing disorder characterized by intermittent hypoxia. Non-alcoholic fatty liver disease is the most common cause of chronic liver disease worldwide. We aimed to evaluate the relationship between OSA and fatty liver. Material/Methods We enrolled 176 subjects to this study who underwent polysomnography (PSG) for suspected OSA. The control group included 42 simple snoring subjects. PSG, biochemical tests, and ultrasonographic examination were performed all subjects. Results The simple snoring and mild, moderate, and severe OSA groups included 18/42 (42.86%), 33/52 (63.5%), 27/34 (79.4%), and 28/48 (79.2%) subjects with hepatosteatosis, respectively. There were significant differences in hepatosteatosis and hepatosteatosis grade between the simple snoring and the moderate and severe OSA groups. Logistic regression analysis showed that BMI and average desaturation were independently and significantly related to hepatic steatosis. Conclusions Our study shows that BMI and the average desaturation contribute to non-alcoholic fatty liver in subjects with OSA. In this regard, sleep apnea may trigger metabolic mitochondrial energy associated processes thereby altering lipid metabolism and obesity as well.

Esophageal squamous papillomatosis

Squamous papillomas of the esophagus are epithelial tumors considered to be benign. They are rare, occurring in 0.01% of individuals at autopsy [1] and 0.07% of individuals in an endoscopy series [2]. Development of extensive esophageal squamous papillomas, otherwise known as squamous papillomatosis of the esophagus (ESP) is even less common [3]. We herein report a case with esophageal squamous papillomatosis.

Fasciola Hepatica Mimicking Malignancy on 18F-Fluorodeoxyglucose-Positron Emission Tomography/Computed Tomography.

A 48-year-old female with complaints of gastrointestinal symptoms such as abdominal pain, fatigue, vomiting, nausea, and weight loss was diagnosed with neuroendocrine tumor after removal of a 2 mm lesion from the stomach with endoscopic biopsy. Her magnetic resonance imaging that was performed due to on-going symptoms showed multiple linear hypointense lesions in the liver. Positron emission tomography/computed tomography (PET/CT) scan was performed for differential diagnosis, which showed high fluorodeoxyglucose (FDG) uptake in these lesions. Clinical and laboratory findings revealed the final diagnosis as Fasciola hepatica. The imaging features of this case is presented to aid in differentiating this infectious disease from malignancy and avoid misdiagnosis on FDG-PET/CT.

Dieulofaloy lezyonunun kombine tedavisi: Olgu sunumu

Dieulafoys lesion is an uncommon, but important, cause of upper gastrointestinal bleeding. Dieulafoys lesion is usually seen in the stomach, but sometimes can be seen in the small or large bowel. Typically, it is located within 6 cm of the esophagogastric junction, generally along the lesser curvature of the stomach. Various methods with endoscopy are used to control the hemostasis due to these lesions, but the most suitable endoscopic treatment method for treating bleeding Dieulafoys lesion is not yet well established. Argon plasma coagulation has been used successfully in upper gastrointestinal bleeding; however, the experience using argon plasma coagulation to treat Dieulafoys lesion is quite limited. Herein, we report a case with a bleeding gastric Dieulafoys lesion that was treated using a combined endoscopic approach with injection therapy and argon plasma coagulation

Enteropathy-associated T-cell lymphoma: involvement of the gastrointestinal tract from the duodenum to the rectum

Enteropathy-associated T-cell lymphoma (EATL) is a rare type of non-Hodgkin’s lymphoma that is commonly associated with celiac disease. The disease is very aggressive with a poor prognosis, and no standardized treatment protocol has been established [1]. An early diagnosis and effective therapy may not be achieved because of the nonspecific clinical and endoscopic findings [2]. The radiologic features of the disease include wall thickening, ulceration, and perforation of the jejunum [3]. 18F-fluorodeoxyglucose (18F-FDG) positron emission tomography/computed tomography is a useful tool for the staging, management, and prognostication of T-cell lymphoma [4]. Here, we present a unique case of EATL with diffuse involvement of the intestine and colon. A 41-year-oldwomanwas admitted to the hospital with abdominal pain and vomiting in September 2014. Her medical history included celiac disease. Free intraabdominal fluid and liver heterogeneity were detected by ultrasound. Computed tomography revealed multiple hypodense lesions without contrast enhancement in the liver and contrast-enhanced nodularity, which supported the diagnosis of peri-