Abstracts / Digestive and Liver Disease 45 (2013) e263–e311 e265 CO5 EFFICACY AND SAFETY OF SINGLE BALLOON ENTEROSCOPY IN A PAEDIATRIC POPULATION A. Salerno, A. Fugazza, E. Manzali, S. Iuliano, I. Lapetina, A. Andreolli, B. Bizzarri, G. Nervi, G.L. de’ Angelis Gastroenterology and Endoscopy Unit, University, Parma, Italy Aim: The small bowel has always been the most difficult gas- trointestinal tract to be evaluated. It is currently examined firstly with wireless capsule endoscopy, but when therapeutic procedure is necessary wireless capsule endoscopy is not useful. In these case single or double balloon enteroscopy can be utilized even in paedi- atric age. Methods: From 2008 to 2012 11 paediatric patients underwent single balloon enteroscopy at the Gastroenterology and Endoscopy Unit, at University of Parma. All patients were first subjected to upper and lower endoscopy, and wireless capsule endoscopy which showed the presence of small bowel lesions. The indications to eval- uate small bowel were: Peutz–Jeghers syndrome (7 patients, 64%), blue rubber nevus syndrome (1 patient, 9%), obscure bleeding (3 patients, 27%). Single balloon enteroscopy was performed under general anesthesia with oro-tracheal intubation and under fluoro- scopic control. The enteroscope was the single balloon Olympus SIF H180. Results: in 5 out of the 7 (5M 2F, mean age 15 years) patients with Peutz–Jeghers syndrome, small bowel polyps (from 1 to 8 polyps) were found in the jejunum (3 patients) and in the ileum (2 patients) and endoscopic polypectomies were performed. In the other 2 patients (2M) the examination was not diagnostic: in the first patient the polip suspected by wireless capsule endoscopy was not observed, in the 2nd case gastric hypotonia and multi- ple narrow duodenum angles did not allow a regular instrument progression until the ileum, where polyps were seen. In 2 of the 3 patients (3M, mean age 18 years) with obscure bleeding, enteroscopy showed diffuse jejunal–ileal ulcerations. The histolog- ical findings in these patients were Crohn’s disease. In the third patient ileal ulceration were seen but histology highlighted a B aggressive lymphoma. In the patient (F, 6 years) with blue rubber nevus syndrome, enteroscopy showed the classic vascular lesions which were treated by polidocanol infiltration. Average time for each procedure was 1 h for diagnostic procedures, 1 h and a half for therapeutic procedures. No complications occurred. Conclusions: Enteroscopy is nowadays a safe and reliable ther- apeutic method even in paediatric age in selected patients. It’s essential, however, to emphasize the need for further studies in paediatric age to increase data regarding efficacy and safety. CO6 HIATAL HERNIA IS NOT ASSOCIATED WITH DYSPEPTIC SYMPTOMS IN CHILDREN E. Scarpato, M. Martinelli, F. Crocetto, V. Mancusi, A. Alessandrella, M.L. Andreozzi, A. Staiano, E. Miele Translational Medical Sciences, Section Pediatrics, University of Naples “Federico II”, Naples, Italy Background and aims: Esophageal hiatal hernia (HH) has been reported to affect from 10 to 50% of adult population. HH is char- acterized by a protrusion of the stomach into the thoracic cavity through a widening of the right crus of the diaphragm. Type I or sliding HH represents the most common subtype. HH has been associated with different symptoms and complications. To best of our knowledge, no data are available in pediatric age. The aims of our study were to estimate prevalence of HH in children undergo- ing upper GI endoscopy (UGE) and to evaluate a possible correlation between HH and dyspeptic symptoms. Methods: We prospectively enrolled 107 consecutive chil- dren (M/F = 49/58; median age = 93 mths; range = 1–216 mths) who underwent UGE with multiple biopsies, from April 2012 to September 2012 at the Department of Pediatrics, University of Naples “Federico II”. The diagnosis of esophagitis was based on histologic features, according to the Yierian-Fiocca classification. A symptomatic score assessment, based on the Rome III Criteria, was administered to the patients over 10 years of age or to the parents of children younger than 10 years. Results: In our population, the prevalence of HH was 31.8%. HH was significantly associated with histologically defined esophagi- tis (p = 0.032; OR: 0.163; 95% CI: 0.03–0.89). Presence of HH was not correlated with dyspeptic symptoms (p = 0.535; OR: 0.948; 95% CI: 0.415–2.166). In addition, no association between dyspeptic symptoms (p = 0.696; OR: 1.886; 95% CI: 0.349–10.190), including vomiting (p = 0.262; 95% CI: 0.563–4.742), and histological findings was found. Conclusion: This is the first pediatric perspective study evalu- ating the prevalence of HH in children. As reported in adults, HH is more likely associated with esophagitis. In addition, our data suggest that, in pediatric age, HH does not play a role in the patho- genesis of dyspeptic symptoms, including vomiting. CO7 AORTIC INTIMA-MEDIA THICKNESS IN CHILDREN WITH INFLAMMATORY BOWEL DISEASE M. Aloi 1 , L. Tromba 2 , V. Rizzo 1 , A. Dilillo 1 , S. Blasi 2 , D.O. Kiltzanidi 2 , G. D’Arcangelo 1 , F. Viola 1 , S. Cucchiara 1 1 Pediatric Gastroenterology and Liver Unit, Sapienza University of Rome, Rome, Italy 2 Surgical Sciences, Sapienza University of Rome, Rome, Italy Background and aims: An accelerated progression of atherosclerosis have been reported in immune-mediated dis- orders, such as inflammatory bowel disease (IBD). Purposes of this study were to determine the presence of early subclinical changes in the cardiovascular system in children affected with IBD and to investigate the influence of traditional and nontraditional risk factors in determining premature atherosclerosis in these patients. Patients and methods: We studied 34 children with IBD [25 Crohn’s disease (CD) and 9 ulcerative colitis (UC); mean age 15.12 years]; 24 subjects served as controls. Demographic data (age, sex, familiarity for diabetes, cardiovascular disease, hypertension, hypercholesterolemia), traditional risk factors for atherosclerosis (blood pressure, body mass index, active and passive smoking, dys- lipidemia), UC and CD activity indexes (Pediatric Ulcerative Colitis Activity Index and Pediatric Crohn’s Disease Activity Index, respec- tively) were evaluated. The IMT of the abdominal aorta (aIMT) was measured by high resolution B-mode ultrasound. Results: IBD patients were significantly more exposed to passive smoking (p = 0.01) had lower cholesterol and higher inflammatory markers values than controls (p = 0.04 and p = 0.04, respectively). aIMT was significantly higher in patients than controls (p < 0.0001). At a univariate analysis inflammatory markers of disease activity were significantly related to higher aIMT values.