Abstracts / Pancreatology 14 (2014) S1eS129S88

overall pancreatic arteriovenous malformation were bleeding (50.6%),pancreatitis (16.9%), portal hypertension (6.7%), and pseudocyst (3.4%). Themost common presenting symptom of pancreatic arteriovenous malfor-mation was gastrointestinal bleeding (47.2%), followed by epigastric pain(46.1%). Surgery (43.8%) was the most common treatment for pancreaticarteriovenous malformation cases, followed by transarterial embolization(11.2%), a combination of surgery and transarterial embolization (10.1%),and radiotherapy (2.2%). No intervention was done for 29.2% of the cases ofpancreatic arteriovenous malformation.

Conclusion: Pancreatic arteriovenous malformation occurs mostcommonly in the pancreatic head; gastrointestinal bleeding is the mainsymptom. Surgical resection of the pancreatic arteriovenous malformationis recommended whenever feasible.

F-004.

New opportunities of treatment of erosive and ulcerative lesions (EUL)of the gastroduodenal zone upon chronic pancreatitis (CP)

Natalya Gubergrits a, Olha Bondarenko b

a Donetsk National Medical University, Ukraineb Lviv National Medical University, Ukraine

Background: EUL in the stomach and duodenum are being developedin about one-third of patients with CP.

Aims: To estimate the effectiveness of rebamipide in the treatment ofEUL of stomach and duodenum in patients with CP.

Patients&methods: Research included104patientswithCPandEULand30 healthy persons. Tissue sectionswere stainedwith hematoxylin and eosinin order to assess the morphological changes of gastric mucosa before andafter treatment. PAS-reaction was performed to measure mucin secretion.Alcian blue staining was conducted upon pH 2.5 for the detection of acidicnon-sulphated mucin and upon pH 1 for the identification of acidic sulfo-mucin. Lectin histochemistry with a panel of eight peroxidase-labeled lectinswas applied for detailed transcript of carbohydrate mucin composition.Neuroendocrine cells in the gastric glands were indicated by sections’ Gri-melius silver impregnation, and Masson silver impregnation was used toidentify serotoninocytes. Patientswere divided into 2 groups: 58 received100mgof rebamipide 3 t.i.d. for 3weeks in addition to thePPIs, and46e only PPIs.

Results: Treatment of patients with inclusion of rebamipide has someadvantages concerning the frequency of epithelialization of erosions andscarring of ulcers, reduced recurrence rate, impact on the psychosomaticstatus of patients. Rebamipide contributes to the reducing inflammatoryinfiltration of gastric mucosa, gastritis activity, increased production ofgastric mucus and improvement of its composition, reducing rate ofhyperplasia of gastrin-producing cells of gastric mucosa.

Conclusion: It’s reasonable to include rebamipide in complex therapyof patients with CP with EUL of stomach and duodenum.

F-005.

Abstract withdrawn.

F-006.

"Solid-looking" and "true" solid serous cystadenoma of the pancreas:A challenging diagnosis at imaging.

Raffaella Pozzi-Mucelli a, Marco Del Chiaro b, Caroline Verbeke c

a Radiology Department, Karolinska University Hospital (Huddinge),SwedenbDivision of Surgery, Department of Clinical Science, Intervention andTechnology (CLINTEC) Karolinska Institutet, SwedencDivision of Pathology,Department of Laboratory Medicine, KarolinskaInstitutet, Sweden

Background: Pancreatic serous cystadenoma (SCA) often has typicalimaging features that may differentiate it from potentially malignantlesions (i.e. MCN, IPMN). However SCA may show atypical radiologicalfindings, that may lead to incorrect diagnosis.

Aims: To report on two cases of pancreatic SCA mimicking neuro-endocrine tumors (NET).

Patients & methods: Two asymptomatic patients (67 and 66 y.o.)were discussed in our Multidisciplinary Conference (MDC) for anincidentally discovered pancreatic lesion, located in the head (6,5cm)and in the tail (8cm) respectively. Multiphase-CT, 68Ga-DOTATOC-PET/CT, EUS- and transabdominal-ultrasound(TAUS)-guided biopsies wereperformed.

Due to impossible differentiation from NET, the MDC decided for distalpancreatic resection for the lesion in the tail and duodenocephalopan-creasectomy for the lesion in the head.

Results: The lesion in the head was solid with strong inhomogeneousenhancement at CT. 68Ga-DOTATOC-PET/CT showed slight uptake(SUVmax¼6.5). EUS-biopsy inadequate. No malignancy at TAUS-biopsy.

The lesion in the tail was almost completely solid and stronglyenhancing at CT with scattered,small cysts within the lesion. 68Ga-DOTA-TOC-PET/CT showed low uptake (SUVmax¼11). No signs of malignancies atEUS/TAUS-biopsies.

Uneventful postoperative course.The final pathological diagnosis wasmicrocystic SCAwith solid parts for

the lesion in the tail and solid SCA for the lesion in the head.Conclusion: SCAs may appear as "solid-looking" tumors with

few cysts or "true" solid and highly hypervascular, mimicking NETs.To our knowledge, these are the first reported SCAs with false pos-itivity at 68Ga-DOTATOC-PET/CT. Hypervascularity at CT reflectsthe prominent capillary network adjacent to the epithelium at path-ology. Small cystic areas in the solid variant are visible only micro-scopically.

F-007.

Internal pancreatic fistulas in a surgical chronic pancreatitis series

Sorin T. Barbu, Mircea Cazacu

4th Surgical Department, University of Medicine and Pharmacy "IuliuHatieganu" Cluj-Napoca, Romania

Background: Internal pancreatic fistulas (IPF) are well-recognizedcomplications of chronic pancreatitis (CP).

Aims: To assess the outcome of IPF patients managed by surgery, and tofind risk factors for IPF.

Materials & methods: We retrospectively identify all IPF patientsoperated between 1994 and 2013 in our Department. We reviewed theclinical features, time to diagnosis, to endoscopic and surgical treatment,patients’ status at the time of surgery, surgical procedures and outcome.Correlation test was used to find risk factors for IPF.

Results: IPF was identified in 9 (3.4%) of 265 CP patients: pancreaticascites (PA) in 7 and pancreaticopleural fistula (PPF) in 2. All patientswere alcoholic males (mean age¼43.7 years, mean CP duration¼5.4years). Mean time to diagnosis was 49 days, from diagnosis to endo-scopic treatment 34 days, and from endoscopy to surgery 44 days. Whenadmitted for surgery, all patients had anemia, high CRP, hypo-proteinemia, and mean BMI¼15.4. One PPF patient had bronchopleuralfistula, and one PA patient died before surgery could be performed.Surgery implied 2 pseudocystojejunostomies and 6 pancreaticojejunos-tomies. In PPF patients, splenectomy was associated. There was no IPFrecurrence (mean follow-up 68 months). We found that alcoholic eti-ology, male sex, recent acute episodes and pain duration >3 years arestrong risk factors for IPF.

Conclusion: IPF occurs in young alcoholic males, early in CP course. Riskfactors presence implies a closer monitoring, aiming at an early diagnosisand endoscopic treatment, followed if it fails by immediate surgery on apatient still in acceptable condition, which reduces medical expenses andhospital stay.