116 32nd World Congress of Internal Medicine (October 24-28, 2014) WCIM 2014
PS 0260 Gastroenterology
Association Between the Upper Gastrointestinal Bleed- ing and the Blood Types
Oylum EKIZTAS1, Derya YILDIRIM1, Selma KARAAHMETOGLU OZKAN1, Erdal ESKIOGLU1
Ankara Numune Treaning Reseach Hospital, Turkey1
Background: Upper gastrointestinal system (GIS) bleeding is a highly costed and a frequently seen problem. In this case study we tried to fi nd the association between the blood types and endoscopic results with the patients whom applied to our hospital with the problem of acute GIS bleeding by examing their blood types and endoscopic results between the years of January 2005 and May 2011.
Methods: 244 hospitalized patients with upper GIS Bleeding were included. Only blood types known and endoscopic examines made patients were taken into consideration.
In order to differenciate, blood type difference was taken into account.
Results: For Ankara zone, the most frequent blood type is A Rh+ with %32.3 ratio. On the other hand, in upper GIS Bleeding patients it is 0Rh+ with %36.5 ratio. When the results compared, 0 Rh+ blood type is more likely to have higher upper GIS bleeding;
whereas, B Rh - type has a lower possibility. No logical difference has been detached between the other groups and the society. When endoscopic results were compared with blood types no logical difference has also been detached. But in duodenum ulcer 0 Rh+(%43.8) is the most frequent blood type and in gastric ulcer it is A Rh+.
Conclusions: Very limited study can be found showing the relation between blood types and GIS Bleeding. In this study conducted it can especially seen that 0 blood type causes duodenal ulcer bleeding. In our study especially 0 Rh+ type causes more upper GIS Bleeding than any other types.
PS 0261 Gastroenterology
Effi cacy, Safety and Tolerability of Two Types of Intra- gastric Balloons Placed in Obese Subjects: A Compara- tive Study
Daniel Fernando ROBLEDO1 F.A.G.E., Argentina1
Background: The intragastric balloon can be used for weight reduction for mild to moderate obesity, weight loss or as a pre- or preoperative choice for morbid obesity -super- obesity. The intragastric balloon is a temporary treatment for obese patients.
Methods: Prospective, double-blind Obesity in 30 patients with type I and type 2 obe- sity: 23 women and 7 men, 43.9 ± 10, 120.3 ± 17 kg, and body mass index (BMI) of 44, 2 ± 5 kg/m2, 10 placing gastric balloons (Lexbal®). 20 -BIB intragastric balloons Al- lergan®). fi lled with 700 ml of saline. Both balls were placed with conscious sedation and general anesthesia withdrawn at 6 months. Intravenous and oral medications are given to control symptoms for 48-72 h. Complications, symptoms, weight and quality of life evaluated by Life Index (GIQLI) every 30/45 days were recorded.
Results: At 6 months, the balloons were removed endoscopically, with a mean weight loss (12.8 ± 8 vs 14.1 ± 8 kg), BMI loss (4.6 ± 3 vs 5.5 ± 3 kg/m2) showed no signifi - cant differences between groups. The withdrawal of the balloons 1 balloon Lexbal not found in the stomach, and three patients required removal of the BIB balloon endos- copy. Tolerance was good in both groups
Conclusions: Both intragastric balloons achieved signifi cant weight loss with good tolerance in obese patients and no serious complications were observed correlated with any of the balloons
PS 0262 Gastroenterology
Endosonographic Findings of Gastric Schwannoma: A Single Center Experience
Jong Min YOON1, Gwang Ha KIM1, Geun Am SONG1, Jeong HEO1, Dong Uk KIM1, Hyun Young WOO1, Bong Eun LEE1, Won LIM1, Key Jo LEE1, Jin Sung LEE1, Seong Jun LEE1 Pusan National University Hospital, Korea1
Background/Aims: Gastrointestinal mesenchymal tumors are originated from the mesenchymal stem cells of the gastrointestinal tract, consisting of gastrointestinal stromal tumors (GIST), leiomyomas or leiomyosarcomas or schwannomas. Schwan- nomas are very rare gastrointestinal mesenchymal tumors and represent benign, slow-growing natures. However, some mesenchymal tumors, such as GISTs, have malignancy potential. Therefore pre-treatment differential diagnosis is required to optimally guide treatment options. We retrospectively reviewed the endosonographic features of twenty-four patients with gastric schwannomas.
Materials and Methods: We evaluated the EUS features in 24 patients with gastric schwannoma confi rmed histopathologic diagnosis. The following EUS features were analyzed: the location, gross shape, presence of ulcer, size, growth pattern, homogene- ity, echogenicity in comparison with normal surrounding muscle layer, originating layer, border distinctness, and presence of marginal halo, echogenic spot and calcifi cation.
Results: Of the 24 lesions, 20 lesions (83.3%) were located in the body, and 2 lesions (8.3%) were in the antrum, 2 lesions (8.3%) were in the fundus. Three lesions (12.5%) showed an ulcer on surface, and intramural growth pattern was more commonly observed (54.1%). 22 lesions (91.6%) were originated in 4th layer, the mean size of tumor was 3.19 cm. All lesions showed hypoechoic echogenicity, and 21 lesions (87.5%) were heterogenous. By comparison with the echogenicity of normal surrounding muscle, 15 lesions (62.5%) showed more hypoechoic echogenicity. The borders were distinct in 21 lesions (87.5%), and marginal halo was observed in 22 lesions (91.6%).
Echogenic spots appeared in 18 lesions (75%) and calcifi cation was in 1 lesion (4%).
Conclusion: The characteristic EUS features of gastric schwannoma are hypoechoic echogenicity (more hypoechoic in comparison with normal surrounding muscle), het- erogeneity, distinct borders, marginal halo and echogenic spots. These EUS features would be useful for differentiating schwannoma from other mesenchymal tumors such as GIST in the stomach.
PS 0263 Gastroenterology
Pepsinogen Levels are Less Affected by the Bacteri- al Load of Helicobacter pylori in the Elderly Than in Younger Patients
Sun-Young LEE1, Jeong Hwan KIM1, In-Kyung SUNG1, Hyung Seok PARK1, Chan Sup SHIM1, Choon Jo JIN1
Konkuk University Medical Center, Korea1
Background: Serum levels of both pepsinogen (PG) I and II tend to increase in sub- jects with Helicobacter pylori infection, but the magnitude of the increase differs markedly between subjects. This study evaluated whether the bacterial load is related to the degree of increase in PG level, and further analyzed whether aging is related to a reduced increase in PG levels due to atrophic changes.
Methods: Consecutive subjects who were diagnosed as H. pylori infection at our center were enrolled for this study based on their serum anti-H. pylori IgG antibody titer (>1.0 AU/ml using a Platelia H. pylori ELISA, Bio-Rad, Marnes-la-Coquette, France). Serologic atrophy was defi ned as a PG I/II ratio of <3.0 and a PG I level of
<70 ng/ml.
Results: Of the 1433 subjects who fulfi lled the study inclusion criteria, 220 (15.4%) were aged =65 years. The H. pylori bacterial load was significantly related to in- creased levels of PG I (p<0.001) and PG II (p<0.001) in subjects aged <65 years (Table 1).
However, PG II levels (p<0.001) but not PG I levels (p=0.094) were related to H. pylori bacterial load in elderly subjects.
Conclusions: In elderly subjects, a higher H. pylori bacterial load does not increase PG I levels, suggesting that fewer of the intrinsic changes that are observed upon H. py- lori infection occur in the aged population due to corpus atrophy. Therefore, serologic
atrophy diagnosed using the PG I/II ratio becomes less sensitive to the bacterial load with aging, and may thus overestimate the degree of gastric atrophy in the elderly.
