AGA Abstracts Figure 1: Prevalence of diabetes by age at time of study enrollment Mo1315 PROGNOSIS OF TYPE 1 AUTOIMMUNE PANCREATITIS AFTER CORTICOSTEROID THERAPY-INDUCED REMISSION IN TERMS OF DIABETES MELLITUS Masaki Miyazawa, Hajime Takatori, Kazuya Kitamura, Eishiro Mizukoshi, Shuichi Kaneko <INTRODUCTION> Although remission induction and maintenance of corticosteroid ther- apy (CST) are extremely effective for autoimmune pancreatitis (AIP), glucose intolerance and development of diabetes mellitus (DM) are often observed during CST for AIP. Prognosis of DM concurrent with AIP is still unclear. Herein, we elucidated prognosis of type 1 AIP after CST-induced remission in terms of DM. <MATERIALS AND METHODS> Among 94 patients who were diagnosed with definitive or probable type 1 AIP or AIP-not otherwise specified (AIP-NOS) based on the International Consensus Diagnostic Criteria (ICDC) and achieved remission due to induction of CST, we could evaluate the change of glucose tolerance over a period of time in 70 patients. A clinical course of DM with type 1 AIP was evaluated before the start of CST and after the time that CST was decreased to less than 10 mg/day. A change in the clinical course of DM was assessed by a change in the HbA1c level calculated by the value of the National Glycohemoglobin Standardization Program (NGSP). We classified a clinical course of DM as improvement, no change or exacerbation in accord- ance with our own definition and examined the association between clinical factors and a clinical course of DM. <RESULTS> 44 of 70 AIP patients (62.9%) showed a complication of DM. The mean age of patients with DM was relatively higher than that of patients without DM (p=0.050). There was no significant difference in sex, body mass index (BMI), serum IgG level, serum IgG4 level, and the presence of diffuse pancreatic parenchymal enlargement between patients with and without DM. Among 44 patients, 17 patients (38.6%) had pre- existing DM, 19 (43.2%) had simultaneous-onset DM, and 8 (18.2%) had CST-induced DM. After the start of CST, 14 patients (31.8%) showed improvement, 14 (31.8%) showed no change, and 16 (36.4%) showed exacerbation or CST-induced DM. Patients with simul- taneous-onset DM were significantly more likely to show improvement of glucose tolerance after the start of CST than that with pre-existing DM (p=0.004). The achievement rates of insulin-free (p=0.017) and medication-free (p=0.002) were significantly higher in patients with simultaneous-onset DM. There was no significant difference in age, sex, BMI, serum IgG level, serum IgG4 level, and the presence of diffuse pancreatic parenchymal enlargement between patients whose DM showed improvement or not. <CONCLUSIONS> AIP had a relatively high rate of complicating DM. Considering that pre-existing DM is refractory to CST, the early induction of CST for AIP with impaired glucose tolerance before the development of irreversible endocrine dysfunction is desirable. CST for DM concurrent with AIP can eventually make the achievement of insulin-free or medication-free, while we must keep in mind that some AIP patients present DM after induction of CST. Mo1316 ARTERIAL PSEUDOANEURYSM IN ACUTE AND CHRONIC PANCREATITIS: CLINICAL PROFILE AND OUTCOME Narendra Dhaka, Rakesh Kochhar, Saroj Sinha, Jayanta Samanta, Raghavendra Prasad, Neha Berry, Vikas Gupta, Thakur Deen Yadav Background: Arterial pseudoaneurysm (PSA) formation is an uncommon complication of pancreatitis and can lead to catastrophic outcome. However its clinical profile, management and outcome data is limited. Aims: To study the clinical profile and outcome of PSA in acute pancreatitis (AP) and chronic pancreatitis (CP). Material and methods: Data of patients with AP and CP seen by us between January 2013 to October 2016 were analysed for PSA documented on computed tomography (CT) angiography or contrast enhanced CT. Details about clinical profile, vessel involvement and outcome were retrieved. Patients were managed either by radiology guided intervention or surgery. Results: Of the 400 patients with pancreatitis, 282 (70.5%) had AP while 118 (29.5%) had CP. Overall, 34 (8.5%) patients, all males, mean age of 39.47±11.67 years, developed PSAs.18 (6.4%) patients with AP and 16 (13%) patients with CP developed PSAs. De novo development of PSA was seen in 18 (52.9%) while 16 (47.1%) had history of prior interventions such as percutaneous catheter drain in 8(23.5%), endoscopic retrograde cholangiopancreaticography in 2 (5.9%), surgery S-676 AGA Abstracts in 4 (11.8%), cystogastrostomy in 2 (5.9%). Commonest clinical presentation was GI bleed (25, 73.5%); in 5 (14.7%) patients PSA was diagnosed during cross sectional imaging while 3 (8.8%) patients presented with pain and 1 (2.9%) patient had both pain and GI bleed. The manifestations of GI bleed were hematemesis (12, 35.3%), melena (9, 26.5%), bleeding through percutaneous drain (7, 20.6%) and haemoglobin drop (2, 5.9%). The diagnosis of PSA was made on CT angiography in 29 patients while the remaining 5 were incidentally detected on CECT. The arteries involved with PSA were splenic artery (15, 44%), gastroduo- denal artery (10, 29.4%), both (2, 5.9%), superior mesenteric artery (1, 2.9%) and others (5, 14.7%). The modes of treatment received were coil embolization (15, 44.1%), percutaneous thrombin injection (4, 11.8%), glue injection (1, 2.9%), surgery (5, 14.7%) and conservative (3, 8.8%). Successful outcome was seen in 31 (91.1%) while re-bleed occurred in 2 (5.3%) and 1 (2.9%) died. There was no significant difference in the clinical profile, vessel involved or outcome in patients with AP and CP except for the latter having larger PSA (>2cm) when compared to the former (50% vs. 12.5%, p = 0.025). Patients with history of prior interven- tions had similar profile as compared to those having de novo PSA development except for the significantly higher need for surgical intervention (35.5% vs. 0%, p=0.014). Conclusion: Arterial PSA occurs more frequently in CP than AP. Management with radiological interven- tion or surgery is successful in majority of the cases. Mo1317 IMPAIRED GLUCOSE HOMEOSTASIS DOES NOT PREDICT GASTROINTESTINAL DYSMOTILITY IN THE POST-OPERATIVE PERIOD FOLLOWING TOTAL PANCREATECTOMY WITH ISLET TRANSPLANTATION (TP-IAT) George Kunnackal John, Vikesh Singh, Rita Kalyani, Michael Quartuccio, Erica Hall, Martin Makary, Zhaoli Sun, Niraj M. Desai, Christi Walsh, Daniel Warren, Ellen M. Stein Introduction TP-IAT is a viable surgical option that is used to improve pain and quality of life (QOL) in patients with refractory chronic pancreatitis. Despite intraportal islet auto- transplantation (IAT), approximately 70% of patients become insulin dependent post TP- IAT at 1 year, with baseline impaired glycemic states being significant predictors. In addition, approximately 40% of patients experience symptoms of chronic gastrointestinal dysmotility post TP-IAT which adversely affects QOL. Although the relationship between gastrointestinal dysmotility and impaired glucose homeostasis is well established, its relationship in the setting of TP-IAT is unknown. Methods We performed a cross-sectional study looking at gastrointestinal dysmotility in all chronic pancreatitis patients who underwent TP-IAT at Johns Hopkins Hospital between August 2011 and November 2015. The Gastroparesis Cardinal Symptom Index (GCSI), Patient Assessment of Gastrointestinal Disorders Symptom Severity Index (PAGI-SYM) and Patient Assessment of Constipation Symptoms (PAC-SYM) questionnaires were used to estimate gastrointestinal dysmotility. Markers for islet function (fasting C-peptide, Insulin levels) and glucose status (Hemoglobin A1c, fasting glucose, 2 hour oral glucose tolerance test) were measured prospectively. Results The response rate for this study was 73% (n=33) and data regarding islet function and glucose status were available for 79% (n=26) of these patients. The overall prevalence of gastrointestinal dysmoti- lity post-TP-IAT was 46% (n=15) with 12% of patients having severe dysmotility symptoms (GCSI > 3), Figure 1. In patients reporting dysmotility symptoms post TP-IAT, the prevalence of at-risk HbA1c, impaired fasting glucose and impaired glucose tolerance at baseline was 20% (n=3), 6.7% (n=1) and 26.7% (n=4) respectively (Figure 2). There was no association between these baseline impaired glycemic states with dysmotility symptoms post TP-IAT. The insulin independence rate was 27% at 1 year. In addition, there was no association between dysmotility symptoms post TP-IAT and insulin dependence at 1 year. Conclusion A significant proportion of patients with chronic pancreatitis report symptoms of gastrointesti- nal dysmotility following TP-IAT. However, the presence of an impaired glycemic state prior to TP-IAT does not predict post-operative gastrointestinal dysmotility in these patients. Figure 1. Prevalence of gastrointestinal dysmotility symptoms post TP-IAT