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Transmesenteric hernias have bimodal distribution and occur in both pediatric and adult patients. In the adult population, the cause is iatrogenic, traumatic, or inflammatory. We report a case of transmesocolic hernia in an elderly person without any preoperative history. An 84-year-old Korean female was admitted with mid-abdominal pain and distension for 1 d. On abdominal computed tomography, we diagnosed transmesocolic hernia with strangulated small bowel obstruction, and performed emergency surgery. The postoperative period was uneventful and she was discharged 11 d after surgery. Hence, it is important to consider the possibility of transmesocolic hernia in elderly patients with signs and symptoms of intestinal obstruction, even in cases with no previous surgery.

s / Pancreatology 14 (2014) S1eS129 S25 Aims: This study was conducted to compare sedation efficiency, safety and satisfaction by endoscopist and assistants between CI and IB of propofol for deep sedation during ERCP. Patients & methods: A total of 212 patients undergone ERCP were randomly assigned to either CI of propofol (n1⁄4106, continuous group (CG)) or midazolam plus IB of propofol (n1⁄4106, intermittent group (IG)). In the CG, propofol was continuously administered via infusion pump and the doses were determined by sedation assistants. In the IG, a loading dose of 2 mg of midazolam and 0.4 mg/kg of propofol was initially injected and repeated bolus injection of 20 mg of propofol was followed. Total dose of propofol, induction/recovery time, patients’ cooperation and adverse events during the procedure were evaluated. Satisfaction scores by patients/endoscopist and difficulty scores of maintaining the sedation by assistants were graded. Results: Induction time and recovery time showed no statistically significant differences between two groups. Satisfaction score by endoscopist was significantly higher in the CG than IG (9.62 vs. 8.06, p Conclusion: Continuous infusion of propofol was more efficient to maintain the constant level of sedation and more comfortable to endoscopist and sedation assistants for deep sedation during ERCP.

of the varices with endoscopy probe was considered as an indicator of that gastric varices were not eradicated. But if pillow sign was negative, it was thought that the varices were eradicated. With EUS doppler examination of the same varices, if there was flow, it was decided that the varices were not eradicated. Except the experienced endoscopist who performed the gastroscopy and EUS, the varicose veins were visualized by two other experienced endoscopists. Kappa statistics were used to evaluate the interobserver agreement. Results: Eighteen patients were included, 10 men (%55) and 8 women (%45) with an average age of 53.4 years (range 19 to 74 years). The etiology of the portal hypertension was splenic vein thrombosis in 2 (% 11.1) patients, portal vein thrombosis in 1 (%5.5) patient, and cirrhosis in other 15 (%83.3) patients. The mean injection session number was 2 (range 1 to 5). Seven (% 38.8) patients who had pillow sign in gastroscopy, had also flow in EUS doppler examination and it was repeated the cyanoacrylate injection. Eleven (%61.2) patients with negative pillow sign that were thought to have successful eradication, had no flow in EUS doppler examination. Conclusion: Endoscopically negative pillow sign is adequate for the eradication decision of the gastric varices which were enjected cyanoacrylate, examination with EUS does not contribute an additional benefit.

Tuberculosis of the sigmoid colon is a rare disorder. An 80-year-old man visited Bongseng Memorial Hospital for medical examination. A colonoscopy was performed, and a lesion in the sigmoid colon that was suspected to be colon cancer was found. A biopsy was performed, and tuberculous enteritis with chronic granulomatous inflammation was diagnosed. Intestinal tuberculosis is most frequent in the ileocecal area, followed by the ascending colon, transverse colon, duodenum, stomach, and sigmoid colon, in descending order. Hence, we report a case of intestinal tuberculosis in the sigmoid colon, which is rare and almost indistinguishable from colon cancer.