Page 39 - Magyar Gasztroenterológiai Társaság 2020. november 6–7. – ONLINE KONGRESSZUS

Előadáskivonatok / Abstracts

counties could be influenced by the quality of colonoscopic Hungary; 9. Vilnius University Hospital Santaros Clinics,
reports. Vilnius, Lithuania; 10. Clinics of Abdominal Surgery,
Nephrourology and Gastroenterology, Faculty of Medicine,
10. IPMN (INTRADUCTAL PAPILLARY MUCINOUS Vilnius University, Vilnius, Lithuania; 11. General Surgery,
NEOPLASM) OF THE PANCREAS IN OUR PRACTICE Consorci Sanitari del Garrof, Sant Pere de Ribes, Spain; 12.
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Bordás L. , Szalai L. , Ilyés S. , Rácz B. , Vágó A. , Crai S. , Department of Transplantation and Liver Surgery, Helsinki
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Netye Z. , Zsóri G. , Fazekas I. , Ottlakán A. , Lichtenstein- University Hospital and University of Helsinki, Helsinki,
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Zábrák J. , Gurzó Z. , Novák J. Finland; 13. County Emergency Clinical Hospital -
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1. Department of Gastroenterology, Pándy Kálmán Hospital, Gastroenterology and University of Medicine, Pharmacy,
Békés County Central Hospital, Gyula; 2. Department of Sciences and Technology, Targu Mures, Romania; 14.
Surgery, Pándy Kálmán Hospital, Békés County Central Department of Laboratory Medicine, Medical School,
Hospital, Gyula; 3. Department of Pathology, Pándy Kálmán University of Pécs, Pécs, Hungary; 15. Department of
Hospital, Békés County Central Hospital, Gyula; 4. Radiology, Medical School, University of Pécs, Pécs,
Endoscopic Laboratory, Pándy Kálmán Hospital, Békés Hungary; 16. First Department of Medicine, Medical School,
County Central Hospital, Gyula University of Pécs, Pécs, Hungary; 17. Department of
Emergency Medicine, Medical School, University of Pécs,
Introduction: The incidence of IPMN (intraductal papillary Pécs, Hungary; 18. Heim Pál National Institute of Pediatrics,
mucinous neoplasm) of the pancreas is 21-33% among the Budapest, Hungary
cystic pancreatic neoplasms and 1-2% among all pancreatic
cancers. In our department, between 2016 and 2019, 89 Objectives: In order to reduce mortality in acute
EUS were performed and 3 cases proved to be IPMN. pancreatitis(AP), enteral feeding(EF) is recommended in the
Case report: A 62-year-old man was admitted to our severe or predicted severe form of the disease. We aimed to
department due to abdominal pain, fever, jaundice and loss investigate the factors leading to the decision to start enteral
of weight. Among the laboratory results we emphasize the feeding and the associations between enteral feeding and
elevated leucocytes and liver enzymes (bilirubin, ALT, AST, the outcome of the disease.
GGT) and CA 19-9 > 2000. Abdominal ultrasound indicated Methods: 1421 prospectively collected cases from 12
dilated intrahepatic ducts, the choledochus width was 15-20 countries were included in the analysis. EF and Non-EF
mm and in the pancreas head there was an inhomogenous patient groups were formed. We have investigated the
hypoechoic mass (48 mm in diameter). ERCP: the papilla associations between the pancreas and inflammation related
showed the fish eye sign (specific for IPMN) and emptying of laboratory parameters (amylase, lipase, C-reactive protein-
big quantity of mucin. The choledochus and Wirsung duct CRP, white blood cell count-WBC, lactate dehydrogenase-
were both dilated and we inserted a 10 Fr stent in the LDH), imaging findings of the pancreas (necrosis, fluid
choledochus. The pancreas showed a fluid mass of 5 cm in collection, pseudocyst) and symptoms (abdominal pain,
diameter. We took biopsies from the papilla. Abdominal CT: vomiting, fever) in relation to the start of EF.
the common bile duct was 20 mm wide and in the pancreas Results: Enteral feeding was applied during hospitalization
head there was a fluid mass of 5 cm in diameter. EUS: from in 26% of mild, 64% of moderately severe and 77% of severe
the peripapillary region we saw a cystic lesion of the cases. High level of CRP (EF:61,6mg/L(Q1-Q3:16-167,1);
pancreas head and the choledochus was dilated. Hystology: Non-EF:43,6mg/L(Q1-Q3:9,8-123,3); p=0,039), WBC
proved intraductal papillary neoplasm of the pancreas. The (EF:12,3G/L(Q1-Q3:10,2-16,3); Non-EF:11,3G/L(Q1-
patient underwent a surgical intervention (cholecysto- Q3:8,3-14,6); p=0,003), LDH (EF:397U/L(Q1-Q3:306,8-524);
duodenostomy). Non-EF:351,8U/L(Q1-Q3:240,3-478,3); p=0,046), the
Conclusions: The incidence of IPMN in our practice, presence of necrosis, pseudocyst, fluid collection (all with
similarly to the literature data is about 3% compared to all p<0,001) and the intensity of abdominal pain (p<0,01) were
pancreas tumors and in the setup of the diagnosis the role of associated with the start of EF. Unfortunately, enteral feeding
EUS, ERCP and CT are crucial. was not applied in 23% of the severe cases and the mortality
was almost double in this group compared to the EF group
11. INSUFFICIENT DECISION MAKING PROCESS (53% vs. 28%).
CONCERNING THE START OF ENTERAL FEEDING IN Conclusion: Decision mechanisms of starting EF seems
ACUTE PANCREATITIS logical, however, there remains substantial proportion of
Bosnyák I. , Márta K. , Gede N. , Vincze Á. , Bajor J. , Izbéki patients with severe AP without EF. Since EF is cost effective
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F. , Hamvas J. , Varga M. , Gódi S. , Németh B. , Takács and has low complication rate if applied correctly, it can be
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T. , Czakó L. , Papp M. , Fehér E. , Mickevicius A. 9,10 , recommended in all cases regardless of laboratory
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Ramirez Maldonado E. , Sallinen V. , Török I. , Pécsi D. , parameters and imaging findings.
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Varjú P. , Miseta A. , Nagy T. , Faluhelyi N. , Márton Z. ,
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Kanizsai P. , Párniczky A. 1,18 , Hegyi P. 1,6,7 , Szentesi A. 12. MULTIPLEX SZINKRON VASTAGBÉL
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1. Institute for Translational Medicine, Medical School, ADENOCARCINOMA MOLEKULÁRIS VIZSGÁLATA ÉS
University of Pécs, Pécs, Hungary; 2. Division of KÖVETÉSE ÚJ GENERÁCIÓS SZEKVENÁLÁS
Gastroenterology, First Department of Medicine, Medical SEGÍTSÉGÉVEL – ESETTANULMÁNY
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School, University of Pécs, Pécs, Hungary; 3. Szent György Bádon E. , Mokánszki A. , Mónus A. , András C. ,
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University Teaching Hospital of Fejér County, Damjanovich L. , Méhes G.
Székesfehérvár, Hungary; 4. Péterfy Hospital and Trauma, 1. Debreceni Egyetem Klinikai Központ, Pathológia Intézet;
Trauma Emergency Room, Budapest, Hungary; 5. Dr. Réthy 2. Debreceni Egyetem Klinikai Központ, Onkológiai Intézet;
Pál Hospital, Békéscsaba, Hungary; 6. Division of 3. Debreceni Egyetem Klinikai Központ, Sebészeti Intézet
Translational Medicine, First Department of Medicine,
Medical School, University of Pécs, Pécs, Hungary; 7. First Bevezetés: A multiplex tumorképződés a vastagbélben, ill. a
Department of Medicine, University of Szeged, Szeged, daganaton belüli szelekció olyan biológiailag eltérő klónokat
Hungary; 8. Department of Internal Medicine, Division of eredményezhetnek, melyek mutációs státuszukból
Gastroenterology, University of Debrecen, Debrecen, következően eltérően reagálnak a kiválasztott terápiára. Az
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Central European Journal of Gastroenterology and Hepatology 37
Volume 6, Supplementum 2 / November 2020