None of hepatic encephalopathy was induced in the sedative groups. The satisfactory assessments of the sedative EVL group were better than the conscious EVL group evaluated by gastroenterologists or cirrhotic patients. Conclusion: Sedation with propofol plus fentanyl is safe for EVL as well as EVS in liver cirrhotic patients. EVL may be easier for gastroenterologists and more comfortable for liver cirrhotic patients with sedation. Key Word(s): 1. sedation; 2. propofol; 3. fentany; 4. liver cirrhosis; Presenting Author: HONGZE ZENG Additional Authors: CHIR 99021 BING HU, YI MOU, HANG YI, WEI LIU, QIMING WANG Corresponding Author: BING HU, HONGZE ZENG Affiliations: West China

Hospital, Sichuan University Objective: A 49-year-old man presented to the emergency department with abdominal pain

for 5 days. Upper gastrointestinal endoscopy at local hospital showed a toothpick embedded in the duodenal flexure. On the day he was admitted to our hospital, the patient reported hematuria. Methods: The patient complained no frequency, urgency or odynuria. His vital sign was stable. Physical exam and laboratory tests were unremarkable. An abdominal CT this website Showed a needle-shaped structure penetrating the duodenal wall into the right kidney, with no vessel injury. The attempt to remove the toothpick by endoscopy was unsuccessful because the toothpick was not seen. A repeat abdominal CT revealed the toothpick was still embedded in the duodenal wall. The patient was indicated for laparotomy and underwent duodenorrhaphy. Results: During surgery, a 6.5-cm toothpick was found. The patient had an uneventful post-operative recovery and was discharged after a week. Conclusion: The diagnosis of foreign body ingestion can sometimes be quite difficult because patients often do not remember ingesting a toothpick or other foreign bodies and gastrointestinal perforation can manifest as other diseases. Therefore, the possibility of gastrointestinal perforation by a foreign body should be isothipendyl considered when treating patients with abdominal pain. Key Word(s): 1.

duodenal perforation; 2. foreign body; 3. hematuria; 4. toothpick; Presenting Author: DONG YANYAN Additional Authors: LI YANQING Corresponding Author: LI YANQING Affiliations: Qilu Hospital Objective: We report case series of confocal laser endoscopic findings in signet ring cell gastric carcinoma. Methods: Confocal laser endoscopy with fluorescein sodium was carried out in twelve patients with signet ring cell gastric carcinoma. We compared macroscopic appearance features. And we captured the specific confocal laser endoscopic findings of signet ring cells showing histological characteristics with solitary large intracytoplasmic vacuoles pushing the nuclei to the periphery of the cell, and they were all confirmed by targeted biopsies. Results: We report case series of confocal laser endoscopic findings in signet ring cell gastric carcinoma.