© 2013 by the American College of Gastroenterology The American Journal of GASTROENTEROLOGY
Abstracts S187
Results: Out of 4,015 colonoscopic encounters, 352 patients satisfed the inclusion criteria for the
study. Tere were 47.1% African Americans, 45.7% Hispanics, 5.5% Caucasians, and 1.7% others. Te
mean age for the cohort was 63.3 years (SD 10.2). Tere were no signifcant diferences in the demo-
graphics among the three groups. Group A, B, and C included 210, 94, and 48 patients, respectively.
Te bowel preparation was rated as poor in 46.6% of A, 52.1% of B, and 50% of C (p=0.6). ADR was
24.3% in A, 20.2% in B, and 27.1% in C (p=0.6). AADR was 12.9% in A, 11.7% in B, and 18.8% in
C (p=0.4). Tere was no statistically signifcant diference in ADR and AADR among the groups on
accounting for bowel preparation.
Conclusion: Te level of control of diabetes may have no impact on the quality of bowel preparation,
adenoma detection rate, and advanced adenoma detection rate. Larger studies are warranted to validate
these fndings.
637
Association of HIV versus Non-HIV Patients with Colorectal Adenomas in a Community Hospital
Seth Lipka, MD, Huafeng Shen, MD, MPH, Supreeya Swarup, MD, Jorge Hurtado-Cordovi, MD, Albin
Abraham, MD, Alex Barnowsky, BS, Josh Mosdale, BS, Qinshi Pan, BS, Jefery Silpe, BS, Svetlana
Fridlyand, BS, Suhas Sreeharshan, BS, Rabab Hajar, MD, Prakash Viswanathan, MD, Paul Mustacchia,
MD. Medicine, Nassau University Medical Center, East Meadow, NY.
Purpose: Although the incidence of malignancies such as Kaposi’s sarcoma, cervical cancer, and
non-Hodgkin’s lymphoma in HIV patients increases, scarce data exists on the association between
HIV and colorectal adenomas. We set out to study the outcomes of our HIV population undergoing
colonoscopy.
Methods: The sample included 113 HIV-positive patients and 386 consecutive patients who
underwent colonoscopies from 2009 to 2011, after excluding those with colon cancer, inflamma-
tory bowel disease, or incomplete colonoscopies. Fisher’s exact χ2 test for categorical variables
and t-test for continuous variables was used to analyze data between groups. Logistic regression
was performed to obtain odds ratios (ORs). SAS 9.3 software was used to perform all statistical
analysis.
Results: There was no statistical difference between the adenoma detection rate between the two
groups 0.90 (0.48, 1.67). Furthermore, evaluation of size greater than 10 mm and multiple colorec-
tal adenomas showed no significant difference between the groups 2.07 (0.62, 6.96), respectively.
Location and size of largest colorectal adenoma was not significantly different between the groups
(Table 1). A separate analysis looking at screening and diagnostic colonsocopies also failed to show
statistical significance between the groups (Table 2).
Conclusion: No statistical difference was found between HIV and non-HIV patients undergoing
colonoscopies. Despite breaking the patients down into screening and diagnostic colonoscopy, no
difference was found in adenoma detection rate, size, number, or location of colorectal adenomas.
Further studies with larger sample size that include viral load and duration of disease may further
delineate a possible association.
638
Sodium Polystyrene Sulfonate (SPS): Sorbitol-Induced Ischemic Colitis
Sadat Rashid, MD,
1
Jefrey Resnick, MD
2
. 1. Gastroenterology, Marshfeld Clinic, Wausau, WI;
2. Marshfeld Clinic, Marshfeld, WI.
Purpose: Sodium polystyrene sulfonate (SPS) is a cation exchange resin administered an osmotic laxa-
tive (e.g., sorbitol), orally or as a retention enema, to treat hyperkalemia. SPS-sorbitol use has been
implicated in colonic necrosis of the gastrointestinal tract. We present a rare case of ischemic colitis
with pseudomembranes following single use of oral rectal SPS-sorbitol administration for treatment
of acute hyperkalemia in a patient with chronic kidney disease.
Am J Gastroenterol 2013; 108:S187–S463; doi:10.1038/ajg.2013.267
CLINICAL VIGNETTES/CASE
REPORTS - ESOPHAGUS
639
Esophageal Involvement as a First Clinical Presentation in a Patient with Newly Diagnosed
Pemphigus Vulgaris and a Review of Literature
Kalaiyarasi Kaliyaperumal, MBBS (Singapore) MRCP (UK), Charles Vu, MBBS. Tan Tock Seng Hospital,
Singapore, Singapore.
Purpose: Sir William Osler once famously said that the mouth is the window to the body.
Fittingly enough, many systemic diseases have oropharyngeal manifestations, and pemphigus
vulgaris is no exception. However, esophageal involvement in pemphigus is a rare manifestation,
and to date, this has only been described in small case series and case reports. However, it is
an important clinical presentation that physicians have to be aware of, as timely intervention
and appropriate therapy can alter clinical outcome in such patients. Here, we report a 57-year-old
woman of Malay descent, who presented with odynophagia and few oral lesions with no cutane-
[637A]
[637B]
[638]