Dorian Jones

Turkey is expanding its military training programmes across Africa, with soldiers from Mali and Niger graduating from a special forces camp as Ankara seeks to deepen ties across the continent.

Nikol Pashinyan’s sweeping re-election in Armenia has raised fresh hopes that the border with Turkey could finally reopen after three decades of closure. The Armenian prime minister campaigned on restoring…

Immunoglobulin light chain (AL) amyloidosis arises from a plasma cell dyscrasia and is characterized by extracellular deposition of misfolded light chains. Gastrointestinal (GI) involvement is uncommon but clinically important because amyloid-related mucosal ischemia and vascular fragility can precipitate significant bleeding.A 65-year-old woman with systemic AL (lambda) amyloidosis with cardiac and renal involvement and stage II IgA lambda multiple myeloma presented with several hours of acute hematochezia. Her hemoglobin was 9.6 g/dL on presentation. Computed tomography angiography showed no active contrast extravasation, with mild-to-moderate distal rectal wall thickening and increased intraluminal fluid in the left colon. Colonoscopy on hospital day three demonstrated an adherent sigmoid clot (22-40 cm from the anal verge) without active bleeding; the examination was limited by clot burden. Four days later, she developed recurrent large-volume hematochezia with hemoglobin nadir of 7.9 g/dL. Repeat colonoscopy on hospital day seven demonstrated sigmoid ulceration at the prior clot site, and biopsies were obtained. Routine histopathology showed ulcerated granulation tissue consistent with ischemic-type mucosal injury. Congo red staining was focally positive for amyloid deposition, confirming colonic amyloid involvement. She was discharged without recurrent hematochezia. This case underscores the diagnostic value of requesting amyloid evaluation (including Congo red staining) when endoscopic findings and routine histology are non-specific, particularly in patients with known or suspected plasma cell dyscrasia and recurrent or unexplained GI bleeding.

Lebanon is emerging as the newest flashpoint in the increasingly strained relations between Turkey and Israel, with the former's President Recep Tayyip Erdogan issuing a stark warning that Turkish security…

Turkey's main opposition says its Western allies are failing to respond as a widening crackdown by President Recep Tayyip Erdogan's government targets its leaders and elected mayors.

Next week's NATO Summit in Ankara is expected to showcase Turkish President Recep Tayyip Erdogan's rising influence within the alliance, as he aims to use the gathering to overcome resistance to crucial arms deals and highlight the rapid growth of Turkey's defence industry.

US President Donald Trump made headlines this week at the Nato summit in Ankara by declaring an end to all sanctions against Turkey, paving the way for the sale of the F-35 stealth fighter jet to the alarm of Greece and Israel.

On 16 July, Turkey marked a decade since the failed coup that shook the nation. Its defeat is widely viewed as the final curtain on military meddling in politics and as the moment when President Erdogan cemented his grip on power, yet the aftershocks for human rights and foreign relations still reverberate.

The Israeli parliament's decision to postpone a vote on recognising the Armenian genocide by Ottoman Turkey is being seen as a triumph for regional diplomacy, as Azerbaijan in particular seeks to avert…

Achalasia is a common esophageal motility disorder defined by impaired relaxation of the gastroesophageal junction (GEJ). Complications can occur secondary to achalasia, such as dysphagia, weight loss, chest pain, aspiration, and esophageal rupture. This report discusses a case of massive esophageal dilatation, also known as megaesophagus, in the setting of achalasia. This case highlights the complications secondary to achalasia, such as aspiration, pneumatic cysts, weight loss, dysphagia, and esophageal dilatation, and describes the multidisciplinary approach needed to manage patients with severe achalasia disease, with gastroenterology, pulmonology, and general surgery interventions required.An 80-year-old male presented to the emergency department with a two-week history of progressively worsening dysphagia, accompanied by an inability to tolerate oral intake for several days. Initial computed tomography imaging revealed marked esophageal dilation with significant retained food debris, consistent with advanced achalasia. Additional imaging identified a right middle lobe pulmonary abscess, presumed secondary to aspiration. The patient had a known history of achalasia, previously managed with esophageal dilation, though they had not required intervention for several years prior to this hospitalization. The patient reported experiencing intermittent episodes of dysphagia since their last treatment; however, these episodes resolved spontaneously and did not prompt evaluation. In this instance, the prolonged duration and worsening of symptoms led to their presentation to the emergency department. The gastroenterology service was consulted for endoscopic evaluation and therapeutic dilation of the stricture. Due to the extent of the esophageal dilatation, measuring approximately 11 cm in diameter, fluoroscopic guidance was required to traverse the GEJ and enter the stomach. Endoscopy confirmed a significantly dilated esophagus with no food residue in the stomach with grossly normal-appearing gastric mucosa. A balloon dilation was successfully performed across the narrowed esophageal segment. Given the patient’s cachectic appearance and evidence of aspiration with pulmonary sequelae, general surgery was consulted for gastrostomy tube placement to minimize aspiration risk and provide nutritional support.Achalasia is a primary esophageal motility disorder characterized by impaired lower esophageal sphincter (LES) relaxation and absent peristalsis of the esophageal body, leading to progressive obstruction and esophageal stasis. Over time, chronic retention of food and secretions can result in marked dilatation of the esophagus, sometimes referred to as megaesophagus when the diameter exceeds 6 cm. While esophageal dilation is a well-recognized complication, extreme dilation, exceeding 10 cm, is rare and may reflect long-standing disease. Prompt diagnosis and referral for cases of achalasia are critical; delays in treatment can lead to severe complications, including aspiration and malnutrition. Management may involve a multidisciplinary approach with gastroenterology and possible general surgery for pneumatic dilation, botulinum toxin injection, and myotomy evaluation, respectively. Timely recognition and coordination between inpatient and outpatient care teams is imperative for optimizing outcomes.