Digestive and Liver Disease 46 (2014) e85–e127

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Digestive and Liver Disease

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Abstracts of the XXI National SIGENP Congress: Posters

PEDIATRIC BOWEL POLYPOSIS: REVIEW OF THEDIAGNOSTIC AND THERAPEUTIC GUIDELINESANALYZING A PEDIATRIC COHORT

Marta Flammini 1,∗, Chiara Pierobon 2, ValentinaMoressa 1, Martelossi Stefano 1, VenturaAlessandro 1

1 Institute for Maternal and Child Health, IRCCSBurlo Garofolo, Università degli Studi di Trieste,Trieste, Italy2 Pediatric Clinic, AOUD S. Maria della Misericordia,Udine, Università degli Studi di Trieste, Italy

Objective: The purpose is to reformulate the guidelines for therecognition and the management of pediatric polyposis in order toobtain efficient and effective diagnosis and follow-up.

Materials and methods: This is a retrospective study on 43pediatric patients with Intestinal Polyposis, which have been fol-lowed at the Pediatric Clinic of the IRCCS Burlo Garofolo in Triestefrom 1994 to 2014.

Results: In 29 patients (67%) was found a isolated juvenile polyp.They were symptomatic at diagnosis: all presented painless rectalbleeding, five also mucus in stools and just one had a prolapsingrectal mass.

Patients with Juvenile Polyposis Syndrome (19%) presentedrecurrent symptoms. The inflammatory and hyperplastic polypswere diagnosed by repeated colonoscopy.

The other patients were affected by Peutz Jeghers Syndrome(PJS) (7%), Familial Adenomatous Polyposis (FAP) (5%) and Ruval-caba Syndrome (2%). These patients did not complained anygastrointestinal symptoms and the diagnosis were supposed by thespecific extraintestinal clinical features or family history.

All patients were treated with serial endoscopic polypectomy.Only one, affected by FAP, underwent to prophylactic colectomy at17 years-old age and died due to a pelvic desmoid tumor.

The follow-up is based on pancolonoscopy, EGDS and videocap-sule enteroscopy at a specific time and an accurate surveillanceprogram to prevent other extraintestinal cancers.

Conclusions: Patients affected by genetic polyposis syndromeshave worse prognosis and no symptoms, therefore is important thatthe pediatrician suspect them thanks to his clinical knowledge.

The follow-up of these patients has to be closer as possible andstrictly follows the guidelines.

http://dx.doi.org/10.1016/j.dld.2014.07.055

LONG AND SHORT TERM COMPLICATIONS OFPERCUTANEOUS ENDOSCOPIC GASTROSTOMY INA PEDIATRIC POPULATION

Silvia Iuliano ∗, Maria Cristina Scorrano, AntoninoSalerno, Federica Gaiani, Benedetta Cavirani,Alessia Ghiselli, Fabiola Fornaroli, FrancescaVincenzi, Gian Luigi De’Angelis

U.O.C. di Gastroenterologia ed Endoscopia Digestiva,Azienda Ospedaliero-Universitaria di Parma, Parma,Italy

Objective: Percutaneous endoscopic gastrostomy (PEG) is rec-ommended in children with feeding problems, especially in thosewith neurological diseases in order to gain suitable weight andnutritional parameters. Aim of this study was to evaluate compli-cations in children underwent to PEG.

Methods: A retrospective study was conducted between 2001and 2013. Impaired feeding were caused by neurological problems(n = 36), malformative syndromes (n = 8), trauma (n = 4), gastroin-testinal diseases (n = 2) and cystic fibrosis (n = 2). The procedurewas performed in operating room under intravenous sedation orunder general anesthesia. All PEG were placed by the same teamof pediatric gastroenterologists with the “pull-through” techniqueand transillumination of light through the abdominal wall. Tubefeeding began after 72 h from procedure. Clinical follow up wascarried out at 1, 3, 6 and 12 months. Complications arose within1 month from tube placement were considered short term, thosearose later were considered long term ones.

Results: 52 patients (31 males, 21 females) aged between 2months and 18 years, median age 6,3 years. Complications occurredin 12 patients (6%), no one during the procedure. Short term com-plications in our patients included gastroparesis (n = 1) that neededconversion to transgastric jejunostomy and PEG dislocation (n = 2).Long term complications included granulation tissue on the stomy(n = 3), PEG dislocation (n = 3), infection of the stomy (n = 1) and gas-tric mucosal ulcerations by the contact with the tube (n = 2). Onecase of breaking disc occurred during the replacement of tube withbutton.

Conclusions: PEG is a safe procedure because allows enteralnutrition with recovery of clinical conditions and quality of lifeimprovement, despite of complications can occur.

http://dx.doi.org/10.1016/j.dld.2014.07.056

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