Scientific Program

Conference Series Ltd invites all the participants across the globe to attend 21st World Congress on Advances in Gastroenterology and Hepatology Melbourne, Australia.

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Scientific Program Day 1

Day 1 :

  • Clinical and Molecular Hepatology

Session Introduction

Sun Young Park

University of Korea, Seoul, Republic of Korea

Title: Comparison of operative outcomes (including depressed postoperative skin scar incidences) between Conventional Linear Skin Closure versus Purse-string Skin Closure in Ileostomy Reversal
Biography:

Sunyoung Park has completed her medical school at27 years from Wonkwang university, College of medicine and  is in PhD course in College of medicine, the catholic university of Korea. She is the cheif resident of general surgery part of same hospital.

Abstract:

Purpose

Ileostomy closure is one of the most frequently performed surgeries. Currently, two techniques comprise most of the stoma reversals performed: conventional linear skin closure (LC) and purse-string skin closure (PS). In this study, we investigated the advantage and disadvantages of two closing methods.Materials and Methods

The retrospectively collected data was based on 116 consecutive patients who underwent ileostomy takedown between October 2015 and January 2019 in the tertiary hospital colorectal surgery part. Conventional linear closure was performed in 67 patients and purse-string suture was performed in 49 patients. The medical records including antibiotics use duration, oral antibiotics use were reviewed and postoperative outcomes, including SSI, OPD visit frequencies, scar features and incisional hernia were analyzed.

Results

LC group shows incisional hernia more than PS groups. (9 vs 3 P=0.029). Postoperative antibiotics use were different (12days vs 3days, p=0.009). And skin depression of scar site were more often in PS groups.( 8 vs 0 ,P=0.02)

Conclusion

Purse-string skin closure showed comparable outcomes in terms of severe complication rates (SSI or incisional hernia) to those of linear skin closure. Thus purse-string skin closure could be a good alternative to the conventional linear closure. But in young, overweight patients PS suture can makes skin dimple after wound healing so it could be considered before which technique is chosen.

Duncan Lyons

Gold Coast University Hospital, Gold Coast, Australia

Title: Missed case of intussusception, a rare cause of abdominal pain in adults: A case report emphasising the imaging findings and review of the literature.
Biography:

Duncan Lyons is a resident medical doctor working at the Gold Coast University Hospital in Australia. He has publishes several articles, with a primary focus on gastrointestinal conditions.

 

Abstract:

Abstract: Abdominal pain is a common adult presentation to emergency departments, outpatient clinics and general practitioners. Although rare, intussusception, a process whereby a segment of the intestine telescopes into the adjoining intestinal lumen, may be the source of pain in adults that present with non-specific abdominal pain. Imaging is the mainstay for intussusception diagnosis, and requires prompt accurate interpretation to prevent complications. A case of a middle-aged male is presented, whom self presented to the emergency department with a four-day history of non-relenting abdominal pain; associated with nausea, vomiting and constipation. Examination revealed involuntary guarding, worse on the right side and the presence of bowel sounds. Following blood tests, CXR and CT imaging, the patient was discharged from the Emergency Department with a suspected passed renal stone. Within days, the patient re-presented to the GP with similar abdominal pain – prompting the GP to request a review of his CT images. It was found that the initial radiologist failed to recognise the subtle presence of intussusception. These findings highlight that, although relatively uncommon, intussusception should be considered as a differential diagnosis in adult patients presenting with intermittent abdominal pain. Moreover, radiologists need to be familiar with the clear, and subtler, radiological signs of this diagnosis. Upon diagnosis, treatment depends on the underlying cause and can vary from conservative treatment to surgical intervention. 

Rima Arini

Padjadjaran University, Indonesia

Title: Abstract: Abdominal pain is a common adult presentation to emergency departments, outpatient clinics and general practitioners. Although rare, intussusception, a process whereby a segment of the intestine telescopes into the adjoining intestinal lumen, may be the source of pain in adults that present with non-specific abdominal pain. Imaging is the mainstay for intussusception diagnosis, and requires prompt accurate interpretation to prevent complications. A case of a middle-aged male is presented, whom self presented to the emergency department with a four-day history of non-relenting abdominal pain; associated with nausea, vomiting and constipation. Examination revealed involuntary guarding, worse on the right side and the presence of bowel sounds. Following blood tests, CXR and CT imaging, the patient was discharged from the Emergency Department with a suspected passed renal stone. Within days, the patient re-presented to the GP with similar abdominal pain – prompting the GP to request a review of his CT images. It was found that the initial radiologist failed to recognise the subtle presence of intussusception. These findings highlight that, although relatively uncommon, intussusception should be considered as a differential diagnosis in adult patients presenting with intermittent abdominal pain. Moreover, radiologists need to be familiar with the clear, and subtler, radiological signs of this diagnosis. Upon diagnosis, treatment depends on the underlying cause and can vary from conservative treatment to surgical intervention.
Biography:

Rima Arini is affiliated from Padjadjaran University, Indonesia

Abstract:

Introduction: Sacrococcygeal teratomas are rare tumors that develop at the base of the spine by the tailbone (coccyx) known as the sacrococcygeal region and is a congenital (present at birth) growth or tumour that develops at the base of the spine just above the buttocks and its a relatively uncommon tumor affecting neonates, infants, and children with a female preponderance. Age is an important predictor of malignancy in sacrococcygeal tumors. 
Case presentation: We report a rare case of congenital type III cystic teratoma that may be falsely diagnosed as an anterior sacral myelomeningocele. A 1-year-old female patient complained of swelling in the coccyx area and a few weeks later his stomach felt enlarged. On x ray examination, soft tissue mass was found in the coccyx area with decree in the area. Ultrasound shows a solid and cystic components and fluid in the stomach. CT scan examination shows the inhomogenic hypodense mass with a relatively regular border septaic is in the upper abdomen to the pelvic cavity which seems to be related to the left sacrum mass with a size of 17.5 x 8.7 x 16.4 cm in the upper abdomen to the pelvic cavity that appears to be associated with a left sacral mass measuring 5.4 x 4.4 x 6, 6 cm. Then surgery is carried out with the technique of wide resection of benign lesions with coccygectomy, we found that the cyst consisted of a mostly thin, white wall, but also with small posterior narrow nodules.
Conclusion: Early diagnosis and complete excision with removal of the coccyx is associated with good prognosis, so it will help in the selection of management quickly and precisely
 

Chia Chuin Yau

South tynside and Sunderland NHS Trust, United Kingdom.

Title: Missed Colorectal Cancer Following Colonoscopy, Flexible-Sigmoidoscopy, CT Colonography or CT Abdomen in a District Hospital
Biography:

Dr.Chia Chuin Yau is a gastroenterology registrar from North East England deanery currently working at south tynside and sunderland NHS Trust. He has completed his MbChB at University of Leeds, England and obtain MRCP from Royal College of Physician Edinburgh. He have varies poster publication at British Society of Gastroenterology conference in the past. (Up to 100 words)

Abstract:

Introduction
Colorectal cancer (CRC) is the 4th most common cancer in the UK, accounting for 12% of all newly diagnosis cancer. Early diagnosis improves survival and avoiding delayed diagnosis is crucial. We look report the miss rate of CRC in our Trust following investigation of symptomatic, asymptomatic and surveillance patients.
Methods
This is a retrospective review of CRC cases diagnosed between April 2017 and April 2018. We obtain evidence of investigations done in the 3 years prior to diagnosis from endoscopy record, OpenNet patient reports and Radiology report. Evidence regarding previous investigations includes colonoscopy, flexible sigmoidoscopy, computer tomographic colonography (CTC) and computer tomographic abdomen (CT abdomen) was collected.
Results
115 patients were identified of which 11 patients had been investigated within the 3 years prior to diagnosis. 9/11 (82%) had a prior CT abdomen with contrast. 4/9 (44%) were having planned follow up following previous surgery for CRC with average time from prior test of 9 months. 5/9 (56%) patients had CT abdomen for anaemia, rectal bleeding, acute pancreatitis, chronic cough and pleural effusion with an average time from prior test to diagnosis of 12 months. 
1/11 patients (9%) had an earlier colonoscopy. This patient was undergoing annual polyp surveillance. At the prior colonoscopy 18 polyps were removed (tubular adenomas) with plans to complete clearance at a later stage. On this planned follow up colonoscopy 3 months later a transverse colon cancer was diagnosis.
1/11 (9%) patient had a flexible-sigmoidoscopy for left iliac fossa pain and fresh rectal bleeding 18 months before diagnosis. Patient was diagnosed with malignant of appendix unlikely to be related to symptoms.
None of the missed cases were from CTC.
Conclusion
Colonoscopy and CTC is the most reliable test for detecting CRC. CT abdomen have higher miss rates compared to the above. Patients with bowel symptoms with good functioning performance status should proceed with colonoscopy. Non purgative faecally tagged CTC remains an excellent alternative for patients who have comorbidities or not able to tolerate colonoscopy. Clinician should be reminded of the limitations of CT abdomen in detecting CRC. All patients who had curative resection for CRC should be offered a surveillance colonoscopy at 1 year after initial treatment in additional to CT.