And the

RT in cancerous lesions was significantly longer than in healthy pancreas and non-cancerous lesions. With the use of quantification software, as in our study, this visual impression can thus be detected and measured with a sensitivity that is unachievable with subjective visual impressions alone. Conclusion: Contrast MAPK Inhibitor Library quantification software supplements a subjective visual assessment with objective criteria to facilitate the differential diagnosis of focal lesions in pancreatic cancer and non-cancerous lesions of pancreas, and needs further investigation. Key Word(s): 1. EUS; 2. Pancreatic diseases; 3. CHE; Presenting Author: NERUKAVV RADHAKRISHNAN Additional Authors: RAVIK SHARMA, REGI GEORGE, LAURA QUEST Corresponding Author: NERUKAVV RADHAKRISHNAN

Affiliations: The Acute Pennine Hospitals NHS Trust; The Pennine Acute Hospitals NHS Trust Objective: Buried Bumper Syndrome (BBS) is a rare complication of percutaneous endoscopic gastrostomy/jejunostomy (PEG/J) with an incidence of 1.5–1.9%. Ascertain incidence of BBS and review methods used in the management in our hospital Methods: Details of patients who had new PEG/J placed and those who developed BBS between April 1998–March 2013 were obtained from PEG Register kept in Endoscopy Unit. Results: New PEG/J- 918. 32 patients HM781-36B datasheet with 33 episodes of BBS. Male 23 mean age (MA) 51 (22–80), Female 9 MA 64 (34–87). 20/32 had PEG/J placed at Rochdale giving an incidence of 2.17%. Types of PEG: Fresenius 15 Fr-25, Fresenius 9 Fr-3. PEJ: Wilson Cook 20 Fr- 2, Freka-3. Excluding 8 patients in whom the date of insertion of PEG/J not known mean duration between insertion and BBS diagnosis was 28.4 months (3–65 months). BBS successfully removed at index gastroscopy by: Balloon traction /push technique -in 10/33 cases (in 9 patients), Forceps pull-1, Quill technique-1. In 13 patients 9 Fr and in 1 patient 15 Fr Fresenius gastrostomy tube through the bumper track placed with continuation of feeding. 8/14 of the above (57%) had their

buried flanges gradually 上海皓元 resurfaced and later removed endoscopically after a mean of 4.7 months (1–20 months). Remaining 7 patients – 1-removed by minilap, 4-side by side PEG placed, 1-jejunal tube placement, 1-died from abdominal wall abscess. Conclusion: Incidence of BBS – 2.17%. 31/33 cases associated with Fresenius make. Buried flange successfully removed endoscopically in 20/33 (61%). Balloon method successful at first attempt in 30%. Our experience suggests in difficult patients, placing a 9 or 15 Fr Fresenius gastrostomy tube via buried bumper track may enable release of buried bumper and facilitate its endoscopic removal at a later stage. Key Word(s): 1. Buried Bumper; 2. Gastrostomy; 3. Complication; 4.