A.F. Celik

P259 Comparative retrospective assessment of prospectively recorded endoscopic and histological findings between CD and GI-TB; the first Eastern European registry data

is recommended as one of imaging techniques for detection of intestinal involvement of CD, but its findings in the deep small intestine have not been well compared to the endoscopic findings. We developed MR enterocolonography (MREC) to assess CD lesions in small intestine and colon simultaneously. On the other hand, device-assisted enteroscopy is able to assess the mucosa in detail, as well as to take histopathological specimen. Additionally, endoscopic therapeutic procedures such as balloon dilatation for stenoses are available. The aim of this study was to evaluate the efficacy of MREC by comparing its findings to those of enteroscopy. Methods: MREC and enteroscopy were performed in the same day in eighty patients. The segmentation and assessment of the endoscopic findings were defined based on modified SES-CD. The terminal ileum was defined up to 10 cm from the ileocecal valve; the proximal ileum was defined as part of bowel extending between the proximal end of the terminal ileum up to 300 cm from the valve; the jejunum was defined as proximal part of small bowel. We summed the three scores of ‘size of ulcers’, ‘ulcerated surface’ and ‘affected surface’, and the active lesions were defined in the following manner; major mucosal lesions (MML: sum 5), all mucosal lesions (AML: sum 1). Major stenoses were defined as the lesions that the scope could not pass through. MREC sensitivity and specificity were studied. Results: The scope was passed in retrograde fashion and reached the proximal ileum in 78 patients (97.1%), the jejunum in 34 patients (42.5%), and the entire intestine in 9 patients (11.3%). In the assessment of active lesions, MREC sensitivities in the colon for MML and AML were 75.0% and 51.0%, while specificities were 91.3% and 94.3%, respectively. MREC sensitivities in the small intestine for MML and AML were 79.2% and 66.0%, while specificities were 89.2% and 95.7%, respectively. As for intestinal damage in the small intestine, MREC sensitivity and specificity for major stenoses were 57.1% and 91.0%, while those for all stenoses were 37.8% and 93.5%, respectively. Conclusions: Our protocol of MREC technique is useful in detecting active lesions in both the small intestine and the colon. However, MR imaging is not sensitive enough in detecting stenosis. Evaluation of active lesions is important to determine medical treatment, while that of intestinal damage is important to determine the indication of surgical or endoscopic treatment. Adequate choice of modalities is required for assessing CD lesions.

P324 The clinical comparative demographic features between inpatient and outpatient of IBD

P324 The clinical comparative demographic features between inpatient and outpatient of IBD S. Sadri1 *, I. Hatemi2, Y. Erzin2, B. Baca3, A.F. Celik2. 1Istanbul University Cerrahpasa Medical Faculty, Internal Medicine, Istanbul, Turkey, 2Istanbul University Cerrahpasa Medical Faculty, Gastroenterology, Istanbul, Turkey, 3Istanbul University Cerrahpasa Medical Faculty, General Surgery, Istanbul, Turkey

P520 Demographic features and long-term follow up outcome comparisons between patients with solo inflammatory bowel disease vs. inflammatory bowel disease and concomitant ankylosing spondylitis

Background: Aim of the study was to compare demographic features and the long term patient outcomes between inflammatory bowel disease (IBD) patients with and without ankylosing spondylitis (AS). Methods: An IBD clinic is run by our team since 1999 currently with 705 CD, 935 UC patients under the same registry. These patients’ files retrospectively were evaluated and 76 patients with IBD+AS [49 with Crohn’s disease (CD), 27 with ulcerative colitis (UC)] were identified and then each IBD+AS patient randomly was matched with the next two adjacent solo IBD patient with the same diagnosis so having 152 IBD (98 CD, 54 UC) patients as the control group. Besides comparing demographic features, the primary endpoint was to compare the rate of intestinal resections between both groups. Age at IBD and/or AS onset, age (if there is any) at resection, the mean follow up time, number of flares needing steroids, medications including the type, dosage and duration, presence of family history, sex, disease location, and behavior, presence of perianal fistulae, smoking status were noted. Patients with indeterminate colitis or AS patients developing intestinal inflammation under NSAID or biologic treatment were excluded. Results: AS significantly was more common in patients with CD (6.9%) than in patients with UC (2.8%) (p = 0.0001). Among 76 patients with IBD+AS, 52 (68%) first presented with IBD, 11 (15%) with AS, and the remaining 13 (17%) had both diagnoses at the same time. The mean age, age at diagnosis or at resection did not disclose any significant difference between both groups. Neither location nor behavior of IBD nor rate of perianal fistulae were different. The mean follow up time was significantly longer in patients with IBD+AS (44.49 vs 28.6mo; p = 0.0011), and the use of biologics, steroids significantly were more common among patients with IBD+AS (37% vs. 9% for biologics, p = 0.000; 43% vs. 28% for steroids, p = 0.026). 33 out of 152 (22%) IBD and 11 out of 76 (14%) IBD+AS patients underwent an intestinal resection (total colectomy for UC, resection for CD) during our follow up (p =NS). The Spearman correlation test identified significant relations between IBD duration, frequency of flares needing steroids and resection, but an age-sex adjusted regression analysis disclosed IBD duration as the only independent predictor for resection (R2 = 0.178; p = 0.016). Conclusions: The present study shows that up to 5% of IBD patients may have AS although it is twice more common in CD compared to UC patients. Patients with IBD+AS do not have a worse disease outcome than solo IBD patients. When both groups are analyzed together the only independent predictor for resection is the duration of IBD. P521 Cytomegalovirus infection and response to influenza vaccination in inflammatory bowel disease patients on anti-TNF therapy L. Guidi1 *, G. Andrisani1, D. Frasca2, P. Cattani3, M. Marzo1, C. Felice1, D. Pugliese1, A. Papa1, G.L. Rapaccini1, B.B. Blomberg2, A. Armuzzi1. 1Catholic University, IBD Unit, Complesso Integrato Columbus, Rome, Italy, 2Miller School of Medicine, Department of Microbiology and Immunology, Miami, United States, 3Catholic University, Clinical Laboratory Unit, Complesso integrato Columbus, Rome, Italy