Results: A 27-year-old male presented twice with
hematochezia over a 2-year period. His evaluation included a normal gastroscopy and a colonoscopy which showed blood in the terminal ileum. Capsule endoscopy confirmed distal small bowel bleeding and single balloon enteroscopy was attempted, but was unsuccessful due visualisation obscured by blood. A mesenteric CT angiogram was normal and the Technetium-99 m pertechnetate PARP inhibitor scintigraphy scan showed radiotracer uptake in the stomach and urinary bladder. He presented to our hospital one year later with the 3rd episode of hematochezia. The mesenteric CT angiogram identified an area of ileal outpouching with enhancement and no activehaemorrhage. Retrograde single balloon enteroscopy showed a diaphragm-like luminal narrowing associated with ulceration and scaring in the proximal ileum. Beyond it, was a diverticulum extruding a small amount of stale blood. The area was tattooed and clipped for localization. Biopsies confirmed
gastric metaplasia. A repeat Meckel’s scan with SPECT-CT imaging showed radiotracer uptake in the diverticulum adjacent to the clip. Laparoscopic ileum resection was performed and the specimen contained a 4.5 cm diverticulum with ectopic gastric and pancreatic tissue. Conclusion: Meckel’s diverticulum is associated with small bowel peptic ulcerations. These RAD001 chemical structure may present withhaemorrhageand a diaphragm-like narrowing of the intestine. A Meckel’s scintigraphy scan although diagnostic, may be false negative at times. These patients
medchemexpress can be further evaluated with balloon enteroscopy. Surgical excision is the recommended treatment and the co-existance of ectopic pancreatic tissue is an extremely rare occurrence. Key Word(s): 1. Meckel’s diverticulum; 2. ectopic pancreas; 3. single balloon enteroscopy Presenting Author: EUNHA CHO Additional Authors: YOOMI PARK, YOO JIN LEE, HYOJIN PARK Corresponding Author: EUNHA CHO Affiliations: Gangnam Severance Hospital, Yonsei University, Gangnam Severance Hospital, Yonsei University, Gangnam Severance Hospital, Yonsei University Objective: Achalasia is one of the most common esophageal motility disorder which is characterized by dysphagia and noncardiac chest pain. Various pathogenesis of achalasia has been suggested that hereditary, degenerative, autoimmune and infectious factor. Impairment of vagal function has been reported in achalasia. Therefore, we aimed to evaulate the autonomic nerve system (ANS) dysfuction in achalasia and correlation of ANS dysfuction and clinical significance in achalasia. Methods: Nineteen patients with achalasia (6M/13F; 47.1 ± 16.3 years) and 10 healthy peoples (4M/6F; 34.8 ± 10.7 years) were prospectively enrolled at Gangnam Severance hospital from June 2013 to June 2014. All patients completed questionnaire for ANS dysfuction symptoms and heart rate valiability test (HRV).