Page 81 - Magyar Gasztroenterológiai Társaság 2020. november 6–7. – ONLINE KONGRESSZUS

Előadáskivonatok / Abstracts

Although the available medication and tools have improved, histology: cystic adenoma and CEA pathognomonic. 23 solid
the importance of this topic remains unchanged: the number lesions: 7 cytology + histology tumor negative, 14 cytology
of anticoagulated patients increased, more people are taking and histology positive. 2 false negative.
antiplatelet agents, and new types of oral anticoagulants Results: For 25 patients, cytology and histology samples
have been emerging lately. were taken. Specificity: 100 per cent, sensitivity: 88 per cent.
Methods: Medication, localization of bleeding, and the need Compared to our earlier results calculated for solid
for transfusion for patients with upper and lower pancreatic lesions sensitivity was 87 per cent.
gastrointestinal bleeding were analyzed retrospectively Explanation: In view of the mixed patient sample without
between 2015–2019. Rapid On-Site Examination (ROSE) a sensitivity of 88 per
Results: 412 patients (mean age: over 70 years) were cent is an excellent result. I stress the importance of
involved in our research. 58% of patients were taking simultaneous collection of cytological and histological
anticoagulant drugs and 20% have been receiving at least samples because it could increases sensitivity and is cost-
two platelet aggregation inhibitors. The number of patients effective.
taking new oral anticoagulant (NOAC) have increased: while
in 2015 we had no patients taking NOAC, in 2019 we had 5 124. MANAGEMENT OF INTESTINAL FAILURE WITH
patients. Upper gastrointestinal bleeding, especially gastric HOME PARENTERAL NUTRITION IN INFLAMMATORY
erosion (10%), gastric ulcer (9%), and telangiectasia (7.7%) BOWEL DISEASE – RESULTS FROM OUR CENTRE
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increased. Due to telangiectasia the number of enteroscopic Schäfer E. , Varga A. , Golovics P. , Weisszenberger O. ,
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interventions with argon plasma coagulation increased. Iványi A. , Lestár B. , Árva I. , Zsigmond F. , Gyökeres T. ,
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However, the number of variceal bleedings clearly Herszényi L.
decreased. The occurrence of ischemic colitis, colorectal 1. MHEK Gasztroenterológia; 2. MHEK Sebészet II.; 3.
carcinoma, and post-polypectomy bleeding in the colon MHEK Intenziv terápiás osztály II:
showed an increasing tendency. We have also examined
cases of iatrogenic bleeding caused by anticoagulants. Introduction:: Patients with Crohn's disease are at high risk
Conclusions: Comparing this five-year period's respective for recurrent disease and often undergo multiple operations.
results we can conclude that although the use of proton- Multiple resections and a progressive reduction in bowel
pump inhibitors is now widespread, the number of patients length can lead to the development of short bowel syndrome,
with gastrointestinal bleeding have not decreased, especially a form of intestinal failure that compromises fluid, electrolyte,
among those taking anticoagulants. and nutrient absorption.
Aims: were to evaluate the management and outcome of
123. INDICATIONS FOR A BIOPSY WHILE DOING AN patients with Crohn's disease who develop short bowel
ENDOSCOPIC ULTRASOUND EXAMINATION syndrome (SBS) and to identify risk factors for home
Sahin P. , Vajda K. , Tari K. , Biró P. , Mészáros B. , Tóthné parenteral nutrition complications. We reviewed the records
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Á. , Kovács I. , Rácz S. of adult patients with SBS evaluated over a 7-year period
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1. Department of Gastroenterology, Jahn Ferenc Hospital, (2013-2020).
Budapest; 2. Department of Pathology Jahn Ferenc Hospital, Results: 56% of patients (18/32) with home parenteral
Budapest nutrition (HPN) had Crohn's disease. There were 10 women
and 18 men ranging in age from 23 to 63 years. Eighteen
Objective: Using endoscopic ultrasound (EUS) examination (56%) presented initially with ileocolonic disease, seven
data collected in our endoscopy lab over a period of one year (22%) with colonic disease, and 7 (21%) with small intestinal
we demonstrate the importance and results of biopsies. disease. The interval from initial diagnosis to development of
Method: This is a retrospective study. In 2019 EUS SBS ranged from 2 to 22 years.The number of resections
examinations were performed on 116 patients. In 25 cases leading to SBS varied from 2 to 8. All of the patients are on
simultaneous cytological and biopsy samples were also immunsuppressive treatment, more than >90 of them are on
collected for purposes of a differentiated diagnosis. FNB 22- azathioprine, 3 of them are treated with biologics. Median
G needles: Micromedical, Acquire 22-G, HunMed Micro- duration of HPN is 106-2363 days. We did not meet any
Tech Europe (Trident) 22-G, MTW Puncture Biopsy Forceps. serious metabolic complications. Most of the complications
Patients: Average age: 63.3 years, 13 male, 12 female. FNB was related to different canule infections and
was performed in cases requiring obligatory biopsy: proper thromboembolic events, 4 serious septic complications
oncological treatment of inoperable tumors (mainly tumors of occured. Two patients have died: no one due to HPN
the pancreas), suspicion of GIST, if the focus was on complications, but one from liver failure due to alcoholic liver
preoperative cytoreduction, in cases of pancreatic cirrhosis and the other with chronic lymphoid leukaemia.
cancerous/chronic pancreatitis, conglomerate lymph node Conclusion: In our centre the Crohn's disease remains the
masses, suspicions of neuroendocrine tumors, primary most common cause of SBS. Aggressive resectional
tumors/metastases, and suspicions of lymphoproliferative therapy, surgical complications, and errors in initial diagnosis
disorders or of a malign cystic process. contribute to development of SBS in these patients. Due to
Patients: 25 cases, 23 solid and 2 cystic lesions. Indications: concomittant immunsuppressive treatment HPN
2 cystic lesions, 2 GIST cytoreductions, 2 neuroendocrine complications can occure more often and in more severe
tumor recurrences, 3 conglomerate lymph node masses form. Care of these complex patients with short bowel
(neuroendocrine tumors), 7 inoperable tumors of the syndrome requires a multidisciplinary approach of
pancreas, 1 metastatic primary tumor of the pancreas, 4 physicians, dietitians, and nurses to provide optimal intestinal
tumor/chronic pancreatitis, 2 metastatic recurrences (primary rehabilitation, nutritional support, and improvement in quality
HCC and tumor of the colon), 2 operable tumors of the of life.
pancreas (1 infiltrated the choledochus, the other had an 125. AZ ORALIS ANTICOAGULANS KEZELÉSBEN
st
unclear MRCP), 1 IPMN recurrence. 2 cystic lesions: 1 : RÉSZESÜLŐ BETEGEK COLORECTALIS
benign cytology and biopsy results with high amylase value POLYPECTOMIÁJA. 2 ÉVES BETEGANYAG ELEMZÉSE
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and negative CEA (indication: neuroendocrine tumor in the Sepsi B. , Magyarosi D. , Tóth L. , Balog I. , Pécsi D. , Kokas
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medical history) and 2 : cystic configuration: cytology + M. , Pécsi G.
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Central European Journal of Gastroenterology and Hepatology 79
Volume 6, Supplementum 2 / November 2020